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Pediatr Crit Care Me · Nov 2010
Comment Multicenter StudyTemperature patterns in the early postresuscitation period after pediatric inhospital cardiac arrest.
- Melania M Bembea, Vinay M Nadkarni, Marie Diener-West, Vidya Venugopal, Scott M Carey, Robert A Berg, Elizabeth A Hunt, and American Heart Association National Registry of Cardiopulmonary Resuscitation Investigators.
- Department of Anesthesiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. mbembea1@jhmi.edu
- Pediatr Crit Care Me. 2010 Nov 1; 11 (6): 723-30.
ObjectiveTo 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.DesignMulticenter, national registry of inhospital cardiopulmonary resuscitation.SettingA total of 196 hospitals reporting to the American Heart Association's National Registry of Cardiopulmonary Resuscitation from January 1, 2005 to December 31, 2007.PatientsA 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.InterventionsNone.Measurements And Main ResultsAmong 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).ConclusionsDespite 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.
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