| dc.contributor.author | McPherson, John A. | |
| dc.date.accessioned | 2020-09-04T14:31:47Z | |
| dc.date.available | 2020-09-04T14:31:47Z | |
| dc.date.issued | 2020-01-01 | |
| dc.identifier.citation | Resuscitation | en_US |
| dc.identifier.issn | 0300-9572 | |
| dc.identifier.uri | http://hdl.handle.net/1803/15594 | |
| dc.description | Only Vanderbilt University affiliated authors are listed on VUIR. For a full list of authors, access the version of record at https://www.sciencedirect.com/science/article/pii/S0300957219306690 | en_US |
| dc.description.abstract | Introduction: Targeted temperature management (TTM) after out-of-hospital cardiac arrest (OHCA) has been recommended in international guidelines since 2005. The TTM-trial published in 2013 showed no difference in survival or neurological outcome for patients randomised to 33 degrees C or 36 degrees C, and many hospitals have changed practice. The optimal utilization of TTM is still debated. This study aimed to analyse if a difference in temperature goal was associated with outcome in an unselected international registry population.
Methods: This is a retrospective observational study based on a prospective registry - the International Cardiac Arrest Registry 2. Patients were categorized as receiving TTM in the lower range at 32-34 degrees C (TTM-low) or at 35-37 degrees C (TTM-high). Primary outcome was good functional status defined as cerebral performance category (CPC) of 1-2 at hospital discharge and secondary outcome was adverse events related to TTM. A logistic regression model was created to evaluate the independent effect of temperature by correcting for clinical and demographic factors associated with outcome.
Results: Of 1710 patients included, 1242 (72,6%) received TIM-low and 468 (27,4%) TTM-high. In patients receiving TTM-low, 31.3% survived with good outcome compared to 28.8% in the TTM-high group. There was no significant association between temperature and outcome (p= 0.352). In analyses adjusted for baseline differences the OR for a good outcome with TTM-low was 1.27, 95% CI (0.94-1.73). Haemodynamic instability leading to discontinuation of TTM was more common in TTM-low.
Conclusions: No significant difference in functional outcome at hospital discharge was found in patients receiving lower-versus higher targeted temperature management. | en_US |
| dc.description.sponsorship | Dr Jesper Johnsson has received independent research grants to fund research time from Stig and Ragna Gorthon's Foundation, Thelma Zoega's Foundation, VO FoU Skanevard Sund, the European Regional Development Fund through the Interreg IV A OKS program and government funding of clinical research within the Swedish National Health Services (ALF). No commercial funding was received. The funding organizations did not have any access to the data, nor did they have any influence on data analysis or interpretation. | en_US |
| dc.language.iso | en_US | en_US |
| dc.rights | This article is available under the Creative Commons CC-BY-NC-ND license and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed. | |
| dc.source.uri | https://www.sciencedirect.com/science/article/pii/S0300957219306690 | |
| dc.subject | Cardiac arrest | en_US |
| dc.subject | Out-of-hospital; Outcome | en_US |
| dc.subject | Targeted temperature management | en_US |
| dc.subject | TTM | en_US |
| dc.title | Functional outcomes associated with varying levels of targeted temperature management after out-of-hospital cardiac arrest - An INTCAR2 registry analysis | en_US |
| dc.type | Article | en_US |
| dc.identifier.doi | 10.1016/j.resuscitation.2019.10.020 | |
