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PubMed · 2911533

Extreme pyrexia during bretylium administration.

P E Perlman·W G Adams·N A Ridgeway
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Abstract

Body temperatures exceeding 41.1 degrees C (106 degrees F) occur with relatively few conditions. In the unusual case reported here, the patient's temperature reached 42.3 degrees C (108.2 degrees F) during intravenous administration of bretylium for refractory ventricular fibrillation. The temperature started to drop as soon as the infusion was stopped and was close to normal within four hours. This appears to be the first report of extreme pyrexia resulting from use of this agent.

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Bretylium CompoundsFemaleFeverHumansInfusions, IntravenousMiddle AgedVentricular FibrillationCase ReportsJournal Article

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BibTeXRIS

P E Perlman, W G Adams, N A Ridgeway. 1989. Extreme pyrexia during bretylium administration.. https://doi.org/10.1080/00325481.1989.11700538

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Early, repeated defibrillation is the key to managing ventricular fibrillation (VF). To maximize the likelihood of success, use this five-phase approach, modified from the advanced cardiac life support protocols. Phase I: When a patient is found in VF and with no pulse or signs of life, attempt electrical reversion with a 200-wsec shock, followed if necessary by a 300-wsec and a 360-wsec shock. Phase II: Manage reversible causes of VF with orotracheal intubation, hyperventilation, and epinephrine. Phase III: Use intravenous lidocaine aggressively, followed by a 360-wsec shock. Phase IV: Give bretylium and magnesium sulfate by intravenous push, again followed by a 360-wsec shock. Phase V: Treat refractory VF with repeated 360-wsec shocks, and give further doses of the anti-arrhythmic agents.

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