Target temperature 34 vs. 36°C after out-of-hospital cardiac arrest - a retrospective observational study.

• Intensive care for comatose survivors of cardiac arrest includes targeted temperature management (TTM) to attenuate cerebral reperfusion injury. A recent multi-center clinical trial did not show any difference in mortality or neurological outcome between TTM targeting 33°C or 36°C after out-of-hospital-cardiac-arrest (OHCA). In our institution, the TTM target was changed accordingly from 34 to 36°C. The aim of this retrospective study was to analyze if this change had affected patient outcome.Intensive care registry and medical record data from 79 adult patients treated for OHCA with TTM during 2010 (n=38; 34°C) and 2014 (n=41; 36°C) were analyzed for mortality and neurological outcome were assessed as cerebral performance category. Student's t-test was used for continuous data and Fischer's exact test for categorical data, and multivariable logistic regression was applied to detect influence from patient factors differing between the groups.Witnessed arrest was more common in 2010 (95%) vs. 2014 (76%) (P=0.03) and coronary angiography was more common in 2014 (95%) vs. 2010 (76%) (P=0.02). The number of patients awakening later than 72h after the arrest did not differ. After adjusting for gender, hypertension, and witnessed arrest, neither 1-year mortality (P=0.77), nor 1-year good neurological outcome (P=0.85) differed between the groups.Our results, showing no difference between TTM at 34°C and TTM at 36°C as to mortality or neurological outcome after OHCA, are in line with the previous TTM-trial results, supporting the use of either target temperature in our institution.

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

Adult

Aged

Aged

80 and over

Body Temperature

Coronary Angiography

Critical Care

Female

Humans

Hypertension

complications

mortality

Hypnotics and Sedatives

Hypothermia

Induced

methods

Length of Stay

Male

Middle Aged

Nervous System Diseases

epidemiology

etiology

Out-of-Hospital Cardiac Arrest

diagnostic imaging

mortality

physiopathology

Prognosis

Retrospective Studies

Survival Analysis

Treatment Outcome

Wakefulness

Publication and Content Type

ref (subject category)

art (subject category)