Speed of cooling after cardiac arrest in relation to the intervention effect : a sub-study from the TTM2-trial

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Speed of cooling after cardiac arrest in relation to the intervention effect : a sub-study from the TTM2-trial

Simpson, Rupert F.G. (författare): Basildon and Thurrock University Hospitals,Anglia Ruskin University

Dankiewicz, Josef (författare): 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

Karamasis, Grigoris V. (författare): Anglia Ruskin University,Basildon and Thurrock University Hospitals

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Pelosi, Paolo (författare): Karolinska Institutet

Haenggi, Matthias (författare): Bern University Hospital

Young, Paul J. (författare): Wellington Hospital, New Zealand,Medical Research Institute of New Zealand,Monash University,University of Melbourne

Jakobsen, Janus Christian (författare): University of Southern Denmark,Copenhagen University Hospital

Bannard-Smith, Jonathan (författare): University of Manchester,Manchester University NHS Foundation Trust

Wendel-Garcia, Pedro D. (författare): University Hospital of Zurich

Taccone, Fabio Silvio (författare): Université Libre de Bruxelles (ULB)

Nordberg, Per (författare): Karolinska Institute,Karolinska University Hospital

Wise, Matt P. (författare): University Hospital of Wales

Grejs, Anders M. (författare): Aarhus University Hospital

Lilja, Gisela (författare): 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

Olsen, Roy Bjørkholt (författare): Sørlandet Hospital

Cariou, Alain (författare): Cochin Hospital

Lascarrou, Jean Baptiste (författare): Nantes University Hospital

Saxena, Manoj (författare): Bankstown-Lidcombe Hospital,University of New South Wales

Hovdenes, Jan (författare): Norwegian Radium Hospital

Thomas, Matthew (författare): University Hospitals Bristol NHS Foundation Trust

Friberg, Hans (författare): Lund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital

Davies, John R. (författare): Basildon and Thurrock University Hospitals,Anglia Ruskin University

Nielsen, Niklas (författare): 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

Keeble, Thomas R. (författare): Basildon and Thurrock University Hospitals,Anglia Ruskin University

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2022-11-15
2022
Engelska.
Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535 .- 1466-609X. ; 26:1

Relaterad länk:: http://dx.doi.org/10... (free); visa fler...; https://lup.lub.lu.s...; https://doi.org/10.1...; http://kipublication...; visa färre...

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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.

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Anestesi och int ...

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Av lärosätet: Lunds universitet; Karolinska Institutet

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Speed of cooling after cardiac arrest in relation to the intervention effect : a sub-study from the TTM2-trial

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