TY - JOUR
T1 - Quality of targeted temperature management and outcome of out-of-hospital cardiac arrest patients
T2 - A post hoc analysis of the TTH48 study
AU - De Fazio, Chiara
AU - Skrifvars, Markus B
AU - Søreide, Eldar
AU - Grejs, Anders M
AU - Di Bernardini, Eugenio
AU - Jeppesen, Anni Nørgaard
AU - Storm, Christian
AU - Kjaergaard, Jesper
AU - Laitio, Timo
AU - Rasmussen, Bodil Sten
AU - Tianen, Marjaana
AU - Kirkegaard, Hans
AU - Taccone, Fabio Silvio
AU - TTH48 Investigators
N1 - Copyright © 2021 Elsevier B.V. All rights reserved.
PY - 2021/8
Y1 - 2021/8
N2 - BACKGROUND: No data are available on the quality of targeted temperature management (TTM) provided to out-of-hospital cardiac arrest (OHCA) patients and its association with outcome.METHODS: Post hoc analysis of the TTH48 study (NCT01689077), which compared the effects of prolonged TTM at 33 °C for 48 h to standard 24-h TTM on neurologic outcome. Admission temperature, speed of cooling, rewarming rates, precision (i.e. temperature variability), overcooling and overshooting as post-cooling fever (i.e. >38.0 °C) were collected. A specific score, ranging from 1 to 9, was computed to define the "quality of TTM".RESULTS: On a total of 352 patients, most had a moderate quality of TTM (n = 217; 62% - score 4-6), while 80 (23%) patients had a low quality of TTM (score 1-3) and only 52 (16%) a high quality of TTM (score 7-9). The proportion of patients with unfavorable neurological outcome (UO; Cerebral Performance Category of 3-5 at 6 months) was similar between the different quality of TTM groups (p = 0.90). Although a shorter time from arrest to target temperature and a lower proportion of time outside the target ranges in the TTM 48-h than in the TTM 24-h group, quality of TTM was similar between groups. Also, the proportion of patients with UO was similar between the different quality of TTM groups when TTM 48-h and TTM 24-h were compared.CONCLUSIONS: In this study, high quality of TTM was provided to a small proportion of patients. However, quality of TTM was not associated with patients' outcome.
AB - BACKGROUND: No data are available on the quality of targeted temperature management (TTM) provided to out-of-hospital cardiac arrest (OHCA) patients and its association with outcome.METHODS: Post hoc analysis of the TTH48 study (NCT01689077), which compared the effects of prolonged TTM at 33 °C for 48 h to standard 24-h TTM on neurologic outcome. Admission temperature, speed of cooling, rewarming rates, precision (i.e. temperature variability), overcooling and overshooting as post-cooling fever (i.e. >38.0 °C) were collected. A specific score, ranging from 1 to 9, was computed to define the "quality of TTM".RESULTS: On a total of 352 patients, most had a moderate quality of TTM (n = 217; 62% - score 4-6), while 80 (23%) patients had a low quality of TTM (score 1-3) and only 52 (16%) a high quality of TTM (score 7-9). The proportion of patients with unfavorable neurological outcome (UO; Cerebral Performance Category of 3-5 at 6 months) was similar between the different quality of TTM groups (p = 0.90). Although a shorter time from arrest to target temperature and a lower proportion of time outside the target ranges in the TTM 48-h than in the TTM 24-h group, quality of TTM was similar between groups. Also, the proportion of patients with UO was similar between the different quality of TTM groups when TTM 48-h and TTM 24-h were compared.CONCLUSIONS: In this study, high quality of TTM was provided to a small proportion of patients. However, quality of TTM was not associated with patients' outcome.
KW - Body Temperature
KW - Fever
KW - Humans
KW - Hypothermia, Induced
KW - Out-of-Hospital Cardiac Arrest/therapy
KW - Temperature
U2 - 10.1016/j.resuscitation.2021.06.007
DO - 10.1016/j.resuscitation.2021.06.007
M3 - Journal article
C2 - 34166741
SN - 0300-9572
VL - 165
SP - 85
EP - 92
JO - Resuscitation
JF - Resuscitation
ER -