Association Between Target Temperature Variability and Neurologic Outcomes for Patients Receiving Targeted Temperature Management at 36°C After Cardiac Arrest: A Retrospective Cohort Study

被引：7
作者：
Cordoza, Makayla [1 ]
Thompson, Hilaire [2 ,3 ]
Bridges, Elizabeth [2 ]
Burr, Robert [2 ]
Carlbom, David [4 ]
机构：
[1] Univ Penn, Perelman Sch Med, Div Sleep & Chronobiol, 1013 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA
[2] Univ Washington, Sch Nursing, Biobehav Nursing & Hlth Informat, Seattle, WA 98195 USA
[3] Harborview Med Ctr, Harborview Injury Prevent & Res Ctr, Seattle, WA USA
[4] Univ Washington, Sch Med, Div Pulm Crit Care & Sleep Med, Seattle, WA USA
来源：
THERAPEUTIC HYPOTHERMIA AND TEMPERATURE MANAGEMENT | 2021年 / 11卷 / 02期
关键词：
cardiac arrest; induced hypothermia; induced mild hypothermia; therapeutic hypothermia; AMERICAN-HEART-ASSOCIATION; NEUROMUSCULAR BLOCKADE; THERAPEUTIC HYPOTHERMIA; CARDIOPULMONARY-RESUSCITATION; CARE; SURVIVAL; IMPLEMENTATION; NORMOTHERMIA; GUIDELINE; BYSTANDER;
D O I：
10.1089/ther.2020.0005
中图分类号：
R4 [临床医学];
学科分类号：
1002 ; 100602 ;
摘要：
Maintaining strict temperature control during the maintenance phase of targeted temperature management (TTM) after cardiac arrest may be an important component of clinical care. Temperature variability outside of the goal temperature range may lessen the benefit of TTM and worsen neurologic outcomes. The purpose of this retrospective study of 186 adult patients (70.4% males, mean age 53.8 +/- 15.7 years) was to investigate the relationship between body temperature variability (at least one body temperature measurement outside of 36 degrees C +/- 0.5 degrees C) during the maintenance phase of TTM at 36 degrees C after cardiac arrest and neurologic outcome at hospital discharge. Patients with temperature variability (n = 124 [66.7%]) did not have significantly higher odds of poor neurologic outcome compared with those with no temperature variability (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 0.36-2.82). Use of neuromuscular blocking agents (NMBAs) and having an initial shockable rhythm were associated with both higher odds of good neurologic outcome (shockable rhythm: OR = 10.77, 95% CI = 4.30-26.98; NMBA use: OR = 4.54, 95% CI = 1.34-15.40) and survival to hospital discharge (shockable rhythm: OR = 5.90, 95% CI = 2.65-13.13; NMBA use: OR = 3.03, 95% CI = 1.16-7.90). In this cohort of postcardiac arrest comatose survivors undergoing TTM at 36 degrees C, having temperature variability during maintenance phase did not significantly impact neurologic outcome or survival.
引用
收藏
页码：103 / 109
页数：7
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