Abstract
Introduction: The optimal temperature during targeted temperature management (TTM) for comatose patients resuscitated from out-of-hospital cardiac arrest is unknown. It has been hypothesized that patients with long no-flow times, for example those without bystander CPR would have the most to gain from temperature management at lower temperatures. Methods: We analysed data from an international clinical trial randomizing cardiac arrest patients to targeted temperature management at 33 °C and 36 °C for an interaction between no-flow time and intervention group, with neurological function at six months after cardiac arrest as the primary outcome. A cerebral performance category (CPC) score of 1 or 2 was considered a good outcome. Results: No-flow time (min) was associated with poor neurological outcome (OR 1.13, 95% confidence interval 1.06-1.20, p < 0.001). There was no statistically significant interaction between no flow-time and intervention group (p = 0.11), which may imply that the non-superior effect of 33. °C was consistent for all no-flow times. Bystander CPR was not independently associated with neurological function. Conclusions: TTM at 33. °C compared to 36. °C was not associated with an increased probability of a good neurological function for patients with longer no-flow times.
Original language | English |
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Pages (from-to) | 44-49 |
Number of pages | 6 |
Journal | Resuscitation |
Volume | 99 |
DOIs | |
Publication status | Published - 1 Feb 2016 |
Externally published | Yes |
Keywords
- Cardiac arrest
- Neurological function
- Targeted temperature management