Rapid rewarming rate associated with favorable neurological outcomes in patients with post–cardiac arrest syndrome patients treated with targeted temperature management
Abstract Aim To determine whether the rewarming rate is associated with neurological outcomes in patients with post–cardiac arrest syndrome treated with targeted temperature management (TTM) at 34°C. Methods We conducted a retrospective analysis of a nationwide cohort study of out‐of‐hospital cardia...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Acute Medicine & Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ams2.897 |
| _version_ | 1797374402384363520 |
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| author | Masaru Shin Motoki Fujita Toru Hifumi Yasutaka Koga Takeshi Yagi Takashi Nakahara Masaki Todani Kotaro Kaneda Ryosuke Tsuruta |
| author_facet | Masaru Shin Motoki Fujita Toru Hifumi Yasutaka Koga Takeshi Yagi Takashi Nakahara Masaki Todani Kotaro Kaneda Ryosuke Tsuruta |
| author_sort | Masaru Shin |
| collection | DOAJ |
| description | Abstract Aim To determine whether the rewarming rate is associated with neurological outcomes in patients with post–cardiac arrest syndrome treated with targeted temperature management (TTM) at 34°C. Methods We conducted a retrospective analysis of a nationwide cohort study of out‐of‐hospital cardiac arrest in Japan. Adult patients who experienced a return of spontaneous circulation and completed TTM at 34°C between June 2014 and December 2019 were divided equally into three groups (slow, moderate, and rapid) according to their rewarming rates from 34°C to 36°C. The rates of favorable neurological outcomes (Cerebral Performance Category of 1–2 after 30 days) were compared among the groups, and the adjusted odds ratios for a favorable neurological outcome were calculated for the groups. Results We analyzed 348, 357, and 358 patients in the slow, moderate, and rapid groups, respectively. The periods of rewarming from 34°C to 36°C were 41.9 ± 10.5, 22.4 ± 1.8, and 12.2 ± 3.6 h, respectively. The number of favorable neurological outcomes after 30 days was 121 (34.8%), 125 (35.0%), and 147 (41.1%), respectively, with no significant differences among the three groups (p = 0.145). Rapid rewarming was independently associated with a favorable neurological outcome compared with slow rewarming (adjusted odds ratio 1.57 [95% confidence interval 1.04–2.37]; p = 0.031). Conclusions Rapid rewarming after TTM at 34°C was associated with a more favorable neurological outcome than slow rewarming. |
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| format | Article |
| id | doaj.art-fcc8bc083ae84ba4b905fa8f0cc7833a |
| institution | Directory Open Access Journal |
| issn | 2052-8817 |
| language | English |
| last_indexed | 2024-03-08T19:05:20Z |
| publishDate | 2023-01-01 |
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| record_format | Article |
| series | Acute Medicine & Surgery |
| spelling | doaj.art-fcc8bc083ae84ba4b905fa8f0cc7833a2023-12-28T00:28:39ZengWileyAcute Medicine & Surgery2052-88172023-01-01101n/an/a10.1002/ams2.897Rapid rewarming rate associated with favorable neurological outcomes in patients with post–cardiac arrest syndrome patients treated with targeted temperature managementMasaru Shin0Motoki Fujita1Toru Hifumi2Yasutaka Koga3Takeshi Yagi4Takashi Nakahara5Masaki Todani6Kotaro Kaneda7Ryosuke Tsuruta8Advanced Medical Emergency and Critical Care Center Yamaguchi University Hospital Ube JapanAcute and General Medicine Yamaguchi University Graduate School of Medicine Ube JapanDepartment of Emergency and Critical Care Medicine St. Luke's International Hospital Tokyo JapanAdvanced Medical Emergency and Critical Care Center Yamaguchi University Hospital Ube JapanAdvanced Medical Emergency and Critical Care Center Yamaguchi University Hospital Ube JapanAdvanced Medical Emergency and Critical Care Center Yamaguchi University Hospital Ube JapanAcute and General Medicine Yamaguchi University Graduate School of Medicine Ube JapanAdvanced Medical Emergency and Critical Care Center Yamaguchi University Hospital Ube JapanAdvanced Medical Emergency and Critical Care Center Yamaguchi University Hospital Ube JapanAbstract Aim To determine whether the rewarming rate is associated with neurological outcomes in patients with post–cardiac arrest syndrome treated with targeted temperature management (TTM) at 34°C. Methods We conducted a retrospective analysis of a nationwide cohort study of out‐of‐hospital cardiac arrest in Japan. Adult patients who experienced a return of spontaneous circulation and completed TTM at 34°C between June 2014 and December 2019 were divided equally into three groups (slow, moderate, and rapid) according to their rewarming rates from 34°C to 36°C. The rates of favorable neurological outcomes (Cerebral Performance Category of 1–2 after 30 days) were compared among the groups, and the adjusted odds ratios for a favorable neurological outcome were calculated for the groups. Results We analyzed 348, 357, and 358 patients in the slow, moderate, and rapid groups, respectively. The periods of rewarming from 34°C to 36°C were 41.9 ± 10.5, 22.4 ± 1.8, and 12.2 ± 3.6 h, respectively. The number of favorable neurological outcomes after 30 days was 121 (34.8%), 125 (35.0%), and 147 (41.1%), respectively, with no significant differences among the three groups (p = 0.145). Rapid rewarming was independently associated with a favorable neurological outcome compared with slow rewarming (adjusted odds ratio 1.57 [95% confidence interval 1.04–2.37]; p = 0.031). Conclusions Rapid rewarming after TTM at 34°C was associated with a more favorable neurological outcome than slow rewarming.https://doi.org/10.1002/ams2.897complicationneurological outcomepost–cardiac arrest syndrome (PCAS)rewarming ratetargeted temperature management |
| spellingShingle | Masaru Shin Motoki Fujita Toru Hifumi Yasutaka Koga Takeshi Yagi Takashi Nakahara Masaki Todani Kotaro Kaneda Ryosuke Tsuruta Rapid rewarming rate associated with favorable neurological outcomes in patients with post–cardiac arrest syndrome patients treated with targeted temperature management Acute Medicine & Surgery complication neurological outcome post–cardiac arrest syndrome (PCAS) rewarming rate targeted temperature management |
| title | Rapid rewarming rate associated with favorable neurological outcomes in patients with post–cardiac arrest syndrome patients treated with targeted temperature management |
| title_full | Rapid rewarming rate associated with favorable neurological outcomes in patients with post–cardiac arrest syndrome patients treated with targeted temperature management |
| title_fullStr | Rapid rewarming rate associated with favorable neurological outcomes in patients with post–cardiac arrest syndrome patients treated with targeted temperature management |
| title_full_unstemmed | Rapid rewarming rate associated with favorable neurological outcomes in patients with post–cardiac arrest syndrome patients treated with targeted temperature management |
| title_short | Rapid rewarming rate associated with favorable neurological outcomes in patients with post–cardiac arrest syndrome patients treated with targeted temperature management |
| title_sort | rapid rewarming rate associated with favorable neurological outcomes in patients with post cardiac arrest syndrome patients treated with targeted temperature management |
| topic | complication neurological outcome post–cardiac arrest syndrome (PCAS) rewarming rate targeted temperature management |
| url | https://doi.org/10.1002/ams2.897 |
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