Dantrolene in the Treatment of Refractory Hyperthermic Conditions in Critical Care: A Multicenter Retrospective Study

Purpose: To examine the use of intravenous dantrolene in hospitalized patients. Materials and Methods: Medical Records of patients treated with intravenous dantrolene between 2007 and 2012 at 6 teaching hospitals were reviewed. Temperature, muscle rigidity, creatine kinase levels, and mortality were assessed in association with dantrolene use. Results: Twenty-five patients re- ceived intravenous dantrolene, 9 patients with neuroleptic malignant syndrome (NMS), 8 with hyperthermia due to sepsis, 4 with NMS and sepsis, 2 for malignant hyperthermia (MH), and 2 with hypermetabolic syndrome associated with juvenile diabetic ketoacidosis. Dantrolene was admi- nistered as a bolus of 1 - 3 mg/kg. Core temperature decreased after dantrolene administration in all groups but significant only for MH, NMS cases (Pre 102.3 ± 0.9˚F vs. Post 99.5 ± 0.9˚F; p < 0.001), in Sepsis cases (Pre 104.3 ± 1.5˚F vs. Post 100.6 ± 1.0˚F; p < 0.001). Mean rigidity scores decreased in all groups but significant only for NMS cases, and mean CK did not change significantly in any group. Conclusion: Dantrolene was associated with reductions in temperature and rigidity in hy- perthermia of diverse origins in patients admitted to Intensive care settings.