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Thermoregulation in Post-cardiac Arrest Patients Treated with Targeted Temperature Management

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Thermoregulation in Post-cardiac Arrest Patients Treated with Targeted Temperature Management. / Hoeyer-Nielsen, Anne Kirstine; Holmberg, Mathias J; Christensen, Erika F; Cocchi, Michael N; Donnino, Michael W; Grossestreuer, Anne V.

I: Resuscitation, Bind 162, 05.2021, s. 63-69.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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Hoeyer-Nielsen, Anne Kirstine ; Holmberg, Mathias J ; Christensen, Erika F ; Cocchi, Michael N ; Donnino, Michael W ; Grossestreuer, Anne V. / Thermoregulation in Post-cardiac Arrest Patients Treated with Targeted Temperature Management. I: Resuscitation. 2021 ; Bind 162. s. 63-69.

Bibtex

@article{68eda85ebee94b8c9548ca90ec8d1ed0,
title = "Thermoregulation in Post-cardiac Arrest Patients Treated with Targeted Temperature Management",
abstract = "OBJECTIVE: Evaluate the relationship between heat generation during rewarming in post-cardiac arrest patients receiving targeted temperature management (TTM) as a surrogate of thermoregulatory ability and clinical outcomes.METHODS: This is a prospective observational single-center study conducted at an urban tertiary-care hospital. We included post-cardiac arrest adults who received TTM via surface cooling device between April 2018 and June 2019.RESULTS: Patient heat generation was calculated by multiplying the inverse of the average machine water temperature with time to rewarm to 37°C and standardized in two ways to account for target temperature variation: (1) divided by number of degrees between target temperature and 37°C, and (2) limited to when patient was rewarmed from 36°C to 37°C. The primary outcome was poor neurologic status, defined as Cerebral Performance Category (CPC) score 3-5, and the secondary outcome was 30-day survival. Sixty-six patients were included: 45 (68%) had a CPC-score of 3-5 and 23 (35%) were alive at 30 days. Besides initial rhythm and arrest downtime, baseline characteristics were similar between outcomes. Heat generation was not associated with poor neurological outcome (CPC 3-5: 6.6 [IQR: 6.1, 7.4] versus CPC 1-2: 6.6 [IQR: 5.7, 7.6], p=0.89) or survival at 30 days (non-survivors: 6.6 [IQR: 6.6, 7.4] vs. survivors: 6.6 [IQR: 5.7, 8.0, p=0.78]).CONCLUSION: Heat generation during rewarming was not associated with neurologic outcomes. However, there was a relationship between poor neurological outcome and higher median water temperatures. Time to rewarm was prolonged in patients with poor neurological outcome.",
author = "Hoeyer-Nielsen, {Anne Kirstine} and Holmberg, {Mathias J} and Christensen, {Erika F} and Cocchi, {Michael N} and Donnino, {Michael W} and Grossestreuer, {Anne V}",
note = "Copyright {\textcopyright} 2021. Published by Elsevier B.V.",
year = "2021",
month = may,
doi = "10.1016/j.resuscitation.2021.02.005",
language = "English",
volume = "162",
pages = "63--69",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd.",

}

RIS

TY - JOUR

T1 - Thermoregulation in Post-cardiac Arrest Patients Treated with Targeted Temperature Management

AU - Hoeyer-Nielsen, Anne Kirstine

AU - Holmberg, Mathias J

AU - Christensen, Erika F

AU - Cocchi, Michael N

AU - Donnino, Michael W

AU - Grossestreuer, Anne V

N1 - Copyright © 2021. Published by Elsevier B.V.

PY - 2021/5

Y1 - 2021/5

N2 - OBJECTIVE: Evaluate the relationship between heat generation during rewarming in post-cardiac arrest patients receiving targeted temperature management (TTM) as a surrogate of thermoregulatory ability and clinical outcomes.METHODS: This is a prospective observational single-center study conducted at an urban tertiary-care hospital. We included post-cardiac arrest adults who received TTM via surface cooling device between April 2018 and June 2019.RESULTS: Patient heat generation was calculated by multiplying the inverse of the average machine water temperature with time to rewarm to 37°C and standardized in two ways to account for target temperature variation: (1) divided by number of degrees between target temperature and 37°C, and (2) limited to when patient was rewarmed from 36°C to 37°C. The primary outcome was poor neurologic status, defined as Cerebral Performance Category (CPC) score 3-5, and the secondary outcome was 30-day survival. Sixty-six patients were included: 45 (68%) had a CPC-score of 3-5 and 23 (35%) were alive at 30 days. Besides initial rhythm and arrest downtime, baseline characteristics were similar between outcomes. Heat generation was not associated with poor neurological outcome (CPC 3-5: 6.6 [IQR: 6.1, 7.4] versus CPC 1-2: 6.6 [IQR: 5.7, 7.6], p=0.89) or survival at 30 days (non-survivors: 6.6 [IQR: 6.6, 7.4] vs. survivors: 6.6 [IQR: 5.7, 8.0, p=0.78]).CONCLUSION: Heat generation during rewarming was not associated with neurologic outcomes. However, there was a relationship between poor neurological outcome and higher median water temperatures. Time to rewarm was prolonged in patients with poor neurological outcome.

AB - OBJECTIVE: Evaluate the relationship between heat generation during rewarming in post-cardiac arrest patients receiving targeted temperature management (TTM) as a surrogate of thermoregulatory ability and clinical outcomes.METHODS: This is a prospective observational single-center study conducted at an urban tertiary-care hospital. We included post-cardiac arrest adults who received TTM via surface cooling device between April 2018 and June 2019.RESULTS: Patient heat generation was calculated by multiplying the inverse of the average machine water temperature with time to rewarm to 37°C and standardized in two ways to account for target temperature variation: (1) divided by number of degrees between target temperature and 37°C, and (2) limited to when patient was rewarmed from 36°C to 37°C. The primary outcome was poor neurologic status, defined as Cerebral Performance Category (CPC) score 3-5, and the secondary outcome was 30-day survival. Sixty-six patients were included: 45 (68%) had a CPC-score of 3-5 and 23 (35%) were alive at 30 days. Besides initial rhythm and arrest downtime, baseline characteristics were similar between outcomes. Heat generation was not associated with poor neurological outcome (CPC 3-5: 6.6 [IQR: 6.1, 7.4] versus CPC 1-2: 6.6 [IQR: 5.7, 7.6], p=0.89) or survival at 30 days (non-survivors: 6.6 [IQR: 6.6, 7.4] vs. survivors: 6.6 [IQR: 5.7, 8.0, p=0.78]).CONCLUSION: Heat generation during rewarming was not associated with neurologic outcomes. However, there was a relationship between poor neurological outcome and higher median water temperatures. Time to rewarm was prolonged in patients with poor neurological outcome.

U2 - 10.1016/j.resuscitation.2021.02.005

DO - 10.1016/j.resuscitation.2021.02.005

M3 - Journal article

C2 - 33582256

VL - 162

SP - 63

EP - 69

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -