Rapid rewarming rate associated with favorable neurological outcomes in patients with post–cardiac arrest syndrome patients treated with targeted temperature management

Author:

Shin Masaru1,Fujita Motoki2ORCID,Hifumi Toru3ORCID,Koga Yasutaka1ORCID,Yagi Takeshi1ORCID,Nakahara Takashi1,Todani Masaki2,Kaneda Kotaro1ORCID,Tsuruta Ryosuke12ORCID

Affiliation:

1. Advanced Medical Emergency and Critical Care Center Yamaguchi University Hospital Ube Japan

2. Acute and General Medicine Yamaguchi University Graduate School of Medicine Ube Japan

3. Department of Emergency and Critical Care Medicine St. Luke's International Hospital Tokyo Japan

Abstract

AbstractAimTo 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.MethodsWe 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.ResultsWe 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).ConclusionsRapid rewarming after TTM at 34°C was associated with a more favorable neurological outcome than slow rewarming.

Publisher

Wiley

Subject

Industrial and Manufacturing Engineering,Materials Science (miscellaneous),Business and International Management

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