Cognitive Function in Survivors of Out-of-Hospital Cardiac Arrest After Target Temperature Management at 33°C Versus 36°C

被引：156

作者：

Lilja, Gisela ^{[1
,4
]}

Nielsen, Niklas ^{[4
,5
]}

Friberg, Hans ^{[2
,4
]}

Horn, Janneke ^{[6
]}

Kjaergaard, Jesper ^{[7
]}

Nilsson, Fredrik ^{[3
]}

Pellis, Tommaso ^{[10
]}

Wetterslev, Jorn ^{[8
]}

Wise, Matt P. ^{[11
]}

Bosch, Frank ^{[12
]}

Bro-Jeppesen, John ^{[7
]}

Brunetti, Iole ^{[13
]}

Buratti, Azul Forti ^{[14
]}

Hassager, Christian ^{[7
]}

Hofgren, Caisa ^{[15
]}

Insorsi, Angelo ^{[13
]}

Kuiper, Michael ^{[6
,16
]}

Martini, Alice ^{[10
]}

Palmer, Nicki ^{[11
]}

Rundgren, Malin ^{[2
,4
]}

Rylander, Christian ^{[17
]}

van der Veen, Annelou ^{[6
]}

Wanscher, Michael ^{[9
]}

Watkins, Helen ^{[11
]}

Cronberg, Tobias ^{[1
,4
]}

机构：

[1] Skane Univ Hosp, Dept Neurol & Rehabil Med, S-22185 Lund, Sweden

[2] Skane Univ Hosp, Dept Intens & Perioperat Care, S-22185 Lund, Sweden

[3] Skane Univ Hosp, Ctr Res & Dev, Unit Med Stat & Epidemiol, S-22185 Lund, Sweden

[4] Lund Univ, Dept Clin Sci, Lund, Sweden

[5] Helsingborg Hosp, Dept Anesthesiol & Intens Care, Helsingborg, Sweden

[6] Univ Amsterdam, Acad Med Ctr, Dept Intens Care, NL-1105 AZ Amsterdam, Netherlands

[7] Rigshosp, Copenhagen Univ Hosp, Dept Cardiol, Ctr Heart, DK-2100 Copenhagen, Denmark

[8] Rigshosp, Copenhagen Univ Hosp, Copenhagen Trial Unit, Ctr Clin Intervent Res, DK-2100 Copenhagen, Denmark

[9] Rigshosp, Copenhagen Univ Hosp, Ctr Heart, Dept Cardiothorac Anesthesiol, DK-2100 Copenhagen, Denmark

[10] Santa Maria degli Angeli Hosp, Dept Anaesthesia Intens Care & Emergency Med Serv, Pordenone, Italy

[11] Univ Wales Hosp, Adult Crit Care, Cardiff CF4 4XW, S Glam, Wales

[12] Rijnstate Hosp, Dept Intens Care, Arnhem, Netherlands

[13] Univ Genoa, IRCCS San Martino IST, Dept Anaesthesia & Intens Care, I-16126 Genoa, Italy

[14] Univ London Imperial Coll Sci Technol & Med, Acad Unit Child & Adolescent Psychiat, London, England

[15] Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Sect Clin Neurosci & Rehabil Med, Gothenburg, Sweden

[16] Med Ctr Leeuwarden, Dept Intens Care, Leeuwarden, Netherlands

[17] Sahlgrens Univ Hosp, Dept Anesthesiol & Intens Care, Gothenburg, Sweden

来源：

CIRCULATION | 2015年 / 131卷 / 15期

关键词：

brain; cardiovascular diseases; follow-up studies; heart arrest; myocardial infarction; resuscitation; tests; FRONTAL ASSESSMENT BATTERY; RISK-FACTORS; MEMORY IMPAIRMENT; LIFE; MILD; FAB; DYSFUNCTION; HYPOTHERMIA; DEMENTIA; OUTCOMES;

D O I：

10.1161/CIRCULATIONAHA.114.014414

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background-Target temperature management is recommended as a neuroprotective strategy after out-of-hospital cardiac arrest. Potential effects of different target temperatures on cognitive impairment commonly described in survivors have not been investigated sufficiently. The primary aim of this study was to evaluate whether a target temperature of 33 degrees C compared with 36 degrees C was favorable for cognitive function; the secondary aim was to describe cognitive impairment in cardiac arrest survivors in general. Methods and Results-Study sites included 652 cardiac arrest survivors originally randomized and stratified for site to temperature control at 33 degrees C or 36 degrees C within the Target Temperature Management trial. Survival until 180 days after the arrest was 52% (33 degrees C, n=178/328; 36 degrees C, n=164/324). Survivors were invited to a face-to-face follow-up, and 287 cardiac arrest survivors (33 degrees C, n=148/36 degrees C, n=139) were assessed with tests for memory (Rivermead Behavioural Memory Test), executive functions (Frontal Assessment Battery), and attention/mental speed (Symbol Digit Modalities Test). A control group of 119 matched patients hospitalized for acute ST-segment-elevation myocardial infarction without cardiac arrest performed the same assessments. Half of the cardiac arrest survivors had cognitive impairment, which was mostly mild. Cognitive outcome did not differ (P>0.30) between the 2 temperature groups (33 degrees C/36 degrees C). Compared with control subjects with ST-segment-elevation myocardial infarction, attention/mental speed was more affected among cardiac arrest patients, but results for memory and executive functioning were similar. Conclusions-Cognitive function was comparable in survivors of out-of-hospital cardiac arrest when a temperature of 33 degrees C and 36 degrees C was targeted. Cognitive impairment detected in cardiac arrest survivors was also common in matched control subjects with ST-segment-elevation myocardial infarction not having had a cardiac arrest.

引用

页码：1340 / U77

页数：20

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