Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review
Thermoregulation in Post-cardiac Arrest Patients Treated with Targeted Temperature Management. / Hoeyer-Nielsen, Anne Kirstine; Holmberg, Mathias J; Christensen, Erika F et al.
In: Resuscitation, Vol. 162, 05.2021, p. 63-69.Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review
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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.
KW - Body temperature regulation
KW - Brain injury
KW - Heart arrest
KW - Prognosis
KW - Rewarming
KW - STATEMENT
KW - SURVIVAL
KW - COUNCIL
KW - CARDIOPULMONARY
KW - AMERICAN-HEART-ASSOCIATION
KW - INTERNATIONAL LIAISON COMMITTEE
KW - TASK-FORCE
KW - THERAPEUTIC HYPOTHERMIA
KW - CARDIOVASCULAR CARE COMMITTEE
KW - RESUSCITATION
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 -