Temperature patterns in the early postresuscitation period after pediatric inhospital cardiac arrest.
OBJECTIVE
To describe the prevalence of postarrest hyperthermia among children during the first 24 hrs after inhospital cardiac arrest and to determine the association of persistent postarrest hyperthermia with neurologic outcome and death before hospital discharge.


METHODS
Multicenter, national registry of inhospital cardiopulmonary resuscitation.


METHODS
A total of 196 hospitals reporting to the American Heart Association's National Registry of Cardiopulmonary Resuscitation from January 1, 2005 to December 31, 2007.


METHODS
A total of 547 pediatric patients who suffered inhospital pulseless cardiac arrests reported to the National Registry of Cardiopulmonary Resuscitation, who survived resuscitative efforts and who had the maximum and the minimum temperature in the first 24 hrs postresuscitation reported to the National Registry of Cardiopulmonary Resuscitation.


METHODS
None.


RESULTS
Among 547 children with pulseless cardiac arrests, 238 (43.5%) had at least one temperature of ≥38°C, and 30 (5.5%) had "persistent hyperthermia" (i.e., both the minimum and the maximum temperature of ≥38°C) during the first 24 hrs postarrest. After adjusting for potential confounders by multivariate logistic regression, persistent hyperthermia in the first 24 hrs postarrest was associated with unfavorable neurologic outcome (adjusted odds ratio, 2.7; 95% confidence interval, 1.1-6.7), but not with death before hospital discharge (adjusted odds ratio, 1.2; 95% confidence interval, 0.4-3.4).


CONCLUSIONS
Despite current guidelines to avoid postarrest hyperthermia, a temperature of ≥38°C occurred commonly among children in the first 24 hrs postarrest. Persistent postarrest hyperthermia was associated with unfavorable neurologic outcomes, even after controlling for potential confounding factors.
Bembea
Melania M
MM
Department of Anesthesiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. mbembea1@jhmi.edu
Nadkarni
Vinay M
VM
Diener-West
Marie
M
Venugopal
Vidya
V
Carey
Scott M
SM
Berg
Robert A
RA
Hunt
Elizabeth A
EA
D000293:Adolescent; D001831:Body Temperature / Q000502:physiology*; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D014481:United States / Q000453:epidemiology