Hyperthermia following Cerebral Injury
In the case report following immersion in an excessively heated body of
water, the initial
hyperthermia was a passive consequence of that environment. It was
followed by a prolonged period of resuscitation while laying on 139°C
concrete for at least 20 minutes, resulting in burns to her back and
extremities. As soon as her heart resumed function following CPR, the
superheated blood in her trunk and extremities was returned to her
central circulation and brain. Once she was hospitalized, aggressive
attempts to cool were made. Over the following week or more, her
temperature fluctuated dramatically. Traumatic brain injury is
associated with aseptic hyperthermia in 30-70% of pediatric cases, and
is closely associated with the magnitude of brain injury and subsequent
recovery.20, 23 As a result, current best practice is
to provide cooling to normothermic or lower levels during the period
following resuscitation of cardiac arrest or hospital care following
TBI.23 The longer the brain is allowed to remain in a
hypermetabolic state, the poorer the ultimate
recovery.23