Quality of targeted temperature management and outcome of out-of-hospital cardiac arrest patients: A post hoc analysis of the TTH48 study

Chiara De Fazio; Markus B Skrifvars; Eldar Søreide; Anders M Grejs; Eugenio Di Bernardini; Anni Nørgaard Jeppesen; Christian Storm; Jesper Kjaergaard; Timo Laitio; Bodil Sten Rasmussen; Marjaana Tianen; Hans Kirkegaard; Fabio Silvio Taccone; TTH48 Investigators

doi:10.1016/j.resuscitation.2021.06.007

Quality of targeted temperature management and outcome of out-of-hospital cardiac arrest patients: A post hoc analysis of the TTH48 study

Chiara De Fazio, Markus B Skrifvars, Eldar Søreide, Anders M Grejs, Eugenio Di Bernardini, Anni Nørgaard Jeppesen, Christian Storm, Jesper Kjaergaard, Timo Laitio, Bodil Sten Rasmussen, Marjaana Tianen, Hans Kirkegaard, Fabio Silvio Taccone^*, TTH48 Investigators

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

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.

Original language	English
Journal	Resuscitation
Volume	165
Pages (from-to)	85-92
Number of pages	8
ISSN	0300-9572
DOIs	https://doi.org/10.1016/j.resuscitation.2021.06.007
Publication status	Published - Aug 2021

Keywords

ASSOCIATION
CARDIOPULMONARY
CARE
CORE TEMPERATURE
Cardiac arrest
DURATION
HYPERTHERMIA
IMPLEMENTATION
IMPROVE
Outcome
Quality
RESUSCITATION
THERAPEUTIC HYPOTHERMIA
Targeted temperature management

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10.1016/j.resuscitation.2021.06.007

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De Fazio, C., Skrifvars, M. B., Søreide, E., Grejs, A. M., Di Bernardini, E., Jeppesen, A. N., Storm, C., Kjaergaard, J., Laitio, T., Rasmussen, B. S., Tianen, M., Kirkegaard, H., Taccone, F. S., & TTH48 Investigators (2021). Quality of targeted temperature management and outcome of out-of-hospital cardiac arrest patients: A post hoc analysis of the TTH48 study. Resuscitation, 165, 85-92. https://doi.org/10.1016/j.resuscitation.2021.06.007

@article{5654e462fa4e4f3daa396615cf2b17cc,

title = "Quality of targeted temperature management and outcome of out-of-hospital cardiac arrest patients: A post hoc analysis of the TTH48 study",

abstract = "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.",

keywords = "ASSOCIATION, CARDIOPULMONARY, CARE, CORE TEMPERATURE, Cardiac arrest, DURATION, HYPERTHERMIA, IMPLEMENTATION, IMPROVE, Outcome, Quality, RESUSCITATION, THERAPEUTIC HYPOTHERMIA, Targeted temperature management",

author = "{De Fazio}, Chiara and Skrifvars, {Markus B} and Eldar S{\o}reide and Grejs, {Anders M} and {Di Bernardini}, Eugenio and Jeppesen, {Anni N{\o}rgaard} and Christian Storm and Jesper Kjaergaard and Timo Laitio and Rasmussen, {Bodil Sten} and Marjaana Tianen and Hans Kirkegaard and Taccone, {Fabio Silvio} and {TTH48 Investigators}",

year = "2021",

month = aug,

doi = "10.1016/j.resuscitation.2021.06.007",

language = "English",

volume = "165",

pages = "85--92",

journal = "Resuscitation",

issn = "0300-9572",

publisher = "Elsevier Ireland Ltd.",

}

De Fazio, C, Skrifvars, MB, Søreide, E, Grejs, AM, Di Bernardini, E, Jeppesen, AN, Storm, C, Kjaergaard, J, Laitio, T, Rasmussen, BS, Tianen, M, Kirkegaard, H, Taccone, FS & TTH48 Investigators 2021, 'Quality of targeted temperature management and outcome of out-of-hospital cardiac arrest patients: A post hoc analysis of the TTH48 study', Resuscitation, vol. 165, pp. 85-92. https://doi.org/10.1016/j.resuscitation.2021.06.007

Quality of targeted temperature management and outcome of out-of-hospital cardiac arrest patients: A post hoc analysis of the TTH48 study. / De Fazio, Chiara; Skrifvars, Markus B; Søreide, Eldar et al.
In: Resuscitation, Vol. 165, 08.2021, p. 85-92.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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

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 - ASSOCIATION

KW - CARDIOPULMONARY

KW - CARE

KW - CORE TEMPERATURE

KW - Cardiac arrest

KW - DURATION

KW - HYPERTHERMIA

KW - IMPLEMENTATION

KW - IMPROVE

KW - Outcome

KW - Quality

KW - RESUSCITATION

KW - THERAPEUTIC HYPOTHERMIA

KW - Targeted temperature management

UR - http://www.scopus.com/inward/record.url?scp=85108403537&partnerID=8YFLogxK

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 -

Quality of targeted temperature management and outcome of out-of-hospital cardiac arrest patients: A post hoc analysis of the TTH48 study

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Keywords

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