Hyperthermia: is it an ominous sign after cardiac arrest?

Objective: To clarify the clinical characteristics of hyperthermia at an ea rly stage after resuscitation from cardiac arrest (CA). Materials and metho ds: We reviewed the medical records of 43 adult patients with non-traumatic out-of-hospital CA, who survived for longer than 24 h after admission to o ur intensive care unit (ICU) between January, 1995, and December, 1998. The patients were divided into two groups: a clinical brain death (CBD) group (n = 23) and a non-CBD group (n = 20), and various factors relating to hype rthermia were compared between the two groups. Results: The mean value of p eak axillary temperatures within 72 h of admission was 39.8 +/- 0.9 degrees C for the CBD group, which was significantly greater than 38.3 +/- 0.6 degr eesC for the non-CBD group (P < 0.0001). The time of occurrence of the peak axillary temperature was at 19 +/- 16 h of admission in the CBD group and 20 +/- 18 h in the non-CBD group (not significantly different). There were no significant differences in risk factors relating to the occurrence of hy perthermia. between the two groups, except for the number of patients who r eceived epinephrine at ICU. In 23 patients with a peak axillary temperature of greater than or equal to 39 degreesC during the first 72 h of hospitali zation, brain death was diagnosed in 20 patients, whereas only 3 of 20 pati ents having a peak axillary temperature of < 39 degreesC developed brain de ath (odds ratio, 37.8; 95% confidence interval, 6.72-212.2). Conclusion: Hy perthermia at an early stage after resuscitation from CA may be associated with the outcome of brain death. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.