Risks According to the Timing and Frequency of Hypotension Episodes in Postanoxic Comatose Patients
The aim of this study was to assess the risk of unfavorable outcomes according to the timing of hypotension episodes in cardiac arrest patients. This prospectively conducted multicenter observational study included 1373 out-of-hospital cardiac arrest patients treated with 33 °C targeted temperature...
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| Format: | Article |
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MDPI AG
2020-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/9/2750 |
| _version_ | 1797555670952706048 |
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| author | Yong Hwan Kim Jae Hoon Lee Jung In Seo Dong Hoon Lee Won Young Kim Byung Kook Lee |
| author_facet | Yong Hwan Kim Jae Hoon Lee Jung In Seo Dong Hoon Lee Won Young Kim Byung Kook Lee |
| author_sort | Yong Hwan Kim |
| collection | DOAJ |
| description | The aim of this study was to assess the risk of unfavorable outcomes according to the timing of hypotension episodes in cardiac arrest patients. This prospectively conducted multicenter observational study included 1373 out-of-hospital cardiac arrest patients treated with 33 °C targeted temperature management (TTM). Unfavorable neurological outcome and the incidence of complications were analyzed according to the timing of hypotension. Compared with hypotension before TTM initiation (adjusted hazard ratio (aHR) 1.51), hypotension within 6 h after TTM initiation was associated with an increased risk of unfavorable neurologic outcome (aHR 1.693), and after 24 h of TTM, was connected with decreased risk (aHR 1.277). The risk of unfavorable neurological outcome was gradually reduced over time after TTM initiation. Hypotension, persisting both before and during TTM, demonstrated a greater risk (aHR 2) than transient hypotension (aHR 1.265). Hypotension was correlated with various complications. Differences in lactate levels were persistent, regardless of the initial fluid therapy (<i>p</i> < 0.001). Hypotension showed a strong correlation with unfavorable neurological outcome, especially in the early phase after TTM initiation, and complications. It is essential to manage hypotension that occurs at the beginning of TTM initiation to recover cerebral function in cardiac arrest patients. |
| first_indexed | 2024-03-10T16:50:49Z |
| format | Article |
| id | doaj.art-785653a9402f4d5381e38a6ed13058f3 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T16:50:49Z |
| publishDate | 2020-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-785653a9402f4d5381e38a6ed13058f32023-11-20T11:19:28ZengMDPI AGJournal of Clinical Medicine2077-03832020-08-0199275010.3390/jcm9092750Risks According to the Timing and Frequency of Hypotension Episodes in Postanoxic Comatose PatientsYong Hwan Kim0Jae Hoon Lee1Jung In Seo2Dong Hoon Lee3Won Young Kim4Byung Kook Lee5Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Gyeongsangnam-do 51353, KoreaDepartment of Emergency Medicine, Dong-A University College of Medicine, Busan 49201, KoreaDivision of Convergence Education, Halla University, Wonju 26404, KoreaDepartment of Emergency Medicine, Chonnam National University Medical School, Gwangju 35015, KoreaDepartment of Emergency Medicine, Ulsan University College of Medicine, Seoul 44033, KoreaDepartment of Emergency Medicine, Chonnam National University Medical School, Gwangju 35015, KoreaThe aim of this study was to assess the risk of unfavorable outcomes according to the timing of hypotension episodes in cardiac arrest patients. This prospectively conducted multicenter observational study included 1373 out-of-hospital cardiac arrest patients treated with 33 °C targeted temperature management (TTM). Unfavorable neurological outcome and the incidence of complications were analyzed according to the timing of hypotension. Compared with hypotension before TTM initiation (adjusted hazard ratio (aHR) 1.51), hypotension within 6 h after TTM initiation was associated with an increased risk of unfavorable neurologic outcome (aHR 1.693), and after 24 h of TTM, was connected with decreased risk (aHR 1.277). The risk of unfavorable neurological outcome was gradually reduced over time after TTM initiation. Hypotension, persisting both before and during TTM, demonstrated a greater risk (aHR 2) than transient hypotension (aHR 1.265). Hypotension was correlated with various complications. Differences in lactate levels were persistent, regardless of the initial fluid therapy (<i>p</i> < 0.001). Hypotension showed a strong correlation with unfavorable neurological outcome, especially in the early phase after TTM initiation, and complications. It is essential to manage hypotension that occurs at the beginning of TTM initiation to recover cerebral function in cardiac arrest patients.https://www.mdpi.com/2077-0383/9/9/2750out-of-hospital cardiac arresthypothermiainducedhypotensionshockhemodynamics |
| spellingShingle | Yong Hwan Kim Jae Hoon Lee Jung In Seo Dong Hoon Lee Won Young Kim Byung Kook Lee Risks According to the Timing and Frequency of Hypotension Episodes in Postanoxic Comatose Patients Journal of Clinical Medicine out-of-hospital cardiac arrest hypothermia induced hypotension shock hemodynamics |
| title | Risks According to the Timing and Frequency of Hypotension Episodes in Postanoxic Comatose Patients |
| title_full | Risks According to the Timing and Frequency of Hypotension Episodes in Postanoxic Comatose Patients |
| title_fullStr | Risks According to the Timing and Frequency of Hypotension Episodes in Postanoxic Comatose Patients |
| title_full_unstemmed | Risks According to the Timing and Frequency of Hypotension Episodes in Postanoxic Comatose Patients |
| title_short | Risks According to the Timing and Frequency of Hypotension Episodes in Postanoxic Comatose Patients |
| title_sort | risks according to the timing and frequency of hypotension episodes in postanoxic comatose patients |
| topic | out-of-hospital cardiac arrest hypothermia induced hypotension shock hemodynamics |
| url | https://www.mdpi.com/2077-0383/9/9/2750 |
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