Rhabdomyolysis may develop because of a reduction in blood flow and oxygen delivery, or by impaired ATP production or metabolism and a large number of drugs are implicated. 33 This drug-induced acute renal and liver failures are common, accounting for 20%34 and 50%35 of cases, respectively, suggesting that hyperthermia is only one of a number of mechanisms through which these drugs may cause tissue damage. Cooling While it appears that lower Benperidol degrees of hyperthermia have an improved outcome and less morbidity it is not clear whether a safe level of hyperthermia exists. include hyperthermia, serotonin syndrome and hyponatraemia. Cannabinoids Although not normally associated with cannabinoid use, hyperthermia has been reported.31 It is more common to find a lowering of the core temperature in relation to use of this drug. Problems of intense hyperthermia Despite the myriad conditions causing hyperthermia the systemic effects are similar, raising the possibility that at least some of the effects are due to hyperthermia em per se /em , rather than the underlying aetiology. Perhaps in some situations there is a final common pathway and indeed, artificially induced hyperthermia also often generates the same multi-system effects.32 Cerebral or cognitive dysfunction is a common feature of hyperthermic claims. This may be a recognised side effect of the drug or as a direct result Benperidol of the hyperthermia. Coagulopathy, liver failure and renal failure are common, and rhabdomyolysis and cell damage also happen. Conversely, a number of medicines cause organ and tissue damage self-employed of their hyperthermogenic properties. Rhabdomyolysis may develop because of a reduction in blood flow and oxygen delivery, or by impaired ATP production or rate of metabolism and a large number of medicines are implicated.33 This drug-induced acute renal and liver failures are common, accounting for 20%34 and 50%35 of instances, respectively, suggesting that hyperthermia is only one of a number of mechanisms through which these medicines may cause tissue damage. Cooling While it appears that lower examples of hyperthermia have an improved end result and less morbidity it is not obvious whether a safe level of hyperthermia is Benperidol present. Observational data suggest that the mortality is definitely 13-fold higher at a heat of 39.5 compared with normothermia.3 Whether artificially lowering the temperature has the same Benperidol effect is not known. Antipyretics, for example paracetamol and non-steroidal anti-inflammatory medicines (NSAIDs), are unlikely to work as it has a warmth generation problem and not a hypothalamic-driven one. Furthermore, NSAIDs are likely to contribute to both the clotting abnormalities and the gastrointestinal cellular dysfunction that develop in IL6 hyperthermia.36 Measuring a core rather than peripheral temperature is recommended, like a peripheral temperature may under-read by up to 2 in hyperthermia.37 Conclusions A raised heat from a non-septic cause is common in the critically ill, but is often poorly recognised and diagnosed. Many of the medicines that are used in the rigorous care unit (ICU) have the potential to cause hyperthermia. With growing evidence that hyperthermia causes multi-system effects and can lead to death, increased effort should be made to identify the cause of the heat and understand the mechanisms better. Cooling is probably important; however, the optimum heat is currently unfamiliar. Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the study, authorship, and/or publication of this article. Funding The authors received no Benperidol monetary support for the research, authorship, and/or publication of this article..