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Speed of cooling af...
Speed of cooling after cardiac arrest in relation to the intervention effect : a sub-study from the TTM2-trial
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- Simpson, Rupert F.G. (author)
- Anglia Ruskin University,Basildon and Thurrock University Hospitals
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- Dankiewicz, Josef (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Karamasis, Grigoris V. (author)
- Basildon and Thurrock University Hospitals,Anglia Ruskin University
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- Pelosi, Paolo (author)
- Karolinska Institutet
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- Haenggi, Matthias (author)
- Bern University Hospital
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- Young, Paul J. (author)
- Wellington Hospital, New Zealand,University of Melbourne,Monash University,Medical Research Institute of New Zealand
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- Jakobsen, Janus Christian (author)
- University of Southern Denmark,Copenhagen University Hospital
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- Bannard-Smith, Jonathan (author)
- University of Manchester,Manchester University NHS Foundation Trust
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- Wendel-Garcia, Pedro D. (author)
- University Hospital of Zurich
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- Taccone, Fabio Silvio (author)
- Université Libre de Bruxelles (ULB)
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- Nordberg, Per (author)
- Karolinska Institute,Karolinska University Hospital
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- Wise, Matt P. (author)
- University Hospital of Wales
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- Grejs, Anders M. (author)
- Aarhus University Hospital
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- Lilja, Gisela (author)
- Lund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Brain Injury After Cardiac Arrest,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital
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- Olsen, Roy Bjørkholt (author)
- Sørlandet Hospital
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- Cariou, Alain (author)
- Cochin Hospital
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- Lascarrou, Jean Baptiste (author)
- Nantes University Hospital
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- Saxena, Manoj (author)
- Bankstown-Lidcombe Hospital,University of New South Wales
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- Hovdenes, Jan (author)
- Norwegian Radium Hospital
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- Thomas, Matthew (author)
- University Hospitals Bristol NHS Foundation Trust
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- Friberg, Hans (author)
- Lund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital
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- Davies, John R. (author)
- Basildon and Thurrock University Hospitals,Anglia Ruskin University
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- Nielsen, Niklas (author)
- Lund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SEBRA Sepsis and Bacterial Resistance Alliance,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital
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- Keeble, Thomas R. (author)
- Basildon and Thurrock University Hospitals,Anglia Ruskin University
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(creator_code:org_t)
- 2022-11-15
- 2022
- English.
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In: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535 .- 1466-609X. ; 26:1
- Related links:
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http://dx.doi.org/10... (free)
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Abstract
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- Background: Targeted temperature management (TTM) is recommended following cardiac arrest; however, time to target temperature varies in clinical practice. We hypothesised the effects of a target temperature of 33 °C when compared to normothermia would differ based on average time to hypothermia and those patients achieving hypothermia fastest would have more favorable outcomes. Methods: In this post-hoc analysis of the TTM-2 trial, patients after out of hospital cardiac arrest were randomized to targeted hypothermia (33 °C), followed by controlled re-warming, or normothermia with early treatment of fever (body temperature, ≥ 37.8 °C). The average temperature at 4 h (240 min) after return of spontaneous circulation (ROSC) was calculated for participating sites. Primary outcome was death from any cause at 6 months. Secondary outcome was poor functional outcome at 6 months (score of 4–6 on modified Rankin scale). Results: A total of 1592 participants were evaluated for the primary outcome. We found no evidence of heterogeneity of intervention effect based on the average time to target temperature on mortality (p = 0.17). Of patients allocated to hypothermia at the fastest sites, 71 of 145 (49%) had died compared to 68 of 148 (46%) of the normothermia group (relative risk with hypothermia, 1.07; 95% confidence interval 0.84–1.36). Poor functional outcome was reported in 74/144 (51%) patients in the hypothermia group, and 75/147 (51%) patients in the normothermia group (relative risk with hypothermia 1.01 (95% CI 0.80–1.26). Conclusions: Using a hospital’s average time to hypothermia did not significantly alter the effect of TTM of 33 °C compared to normothermia and early treatment of fever.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- Hypothermia
- Out of hospital cardiac arrest
- Temperature management
- Time to target temperature
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Simpson, Rupert ...
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Dankiewicz, Jose ...
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Karamasis, Grigo ...
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Pelosi, Paolo
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Haenggi, Matthia ...
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Young, Paul J.
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Jakobsen, Janus ...
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Bannard-Smith, J ...
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Wendel-Garcia, P ...
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Taccone, Fabio S ...
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Nordberg, Per
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Wise, Matt P.
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Grejs, Anders M.
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Lilja, Gisela
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Olsen, Roy Bjørk ...
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Cariou, Alain
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Lascarrou, Jean ...
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Saxena, Manoj
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Hovdenes, Jan
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Thomas, Matthew
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Friberg, Hans
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Davies, John R.
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Nielsen, Niklas
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Keeble, Thomas R ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Anesthesiology a ...
- Articles in the publication
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Critical Care
- By the university
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Lund University
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Karolinska Institutet