• Am J Emerg Med · Aug 2021

    The association between neuromuscular blockade use during target temperature management and neurological outcomes.

    • Toru Hifumi, Akihiko Inoue, Hideki Arimoto, Naohiro Yonemoto, Yasuhiro Kuroda, Yoshio Tahara, Kenya Kawakita, Hiroyuki Yokoyama, Ken Nagao, Hiroshi Nonogi, and J-PULSE-Hypo Investigators.
    • Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Japan; Emergency Medical Center, Kagawa University Hospital, Japan. Electronic address: hifumitoru@gmail.com.
    • Am J Emerg Med. 2021 Aug 1; 46: 289-294.

    BackgroundTo date, no study has comprehensively analyzed the association between neuromuscular blockade (NMB) during target temperature management (TTM) and the neurological outcomes after out-of-hospital cardiac arrest (OHCA) using a multicenter dataset. We aimed to examine the association between NMB during TTM after cardiac arrest and neurological outcomes after OHCA.MethodsThis study was a secondary analysis of the Japanese Population-based Utstein-style study with defibrillation and basic/advanced Life Support Education and implementation-Hypothermia (J-PULSE-HYPO) study registry. The exposure of the current study was the use of NMB during TTM. The primary outcome was favorable neurological outcome, i.e., a cerebral performance category of 1-2, at hospital discharge.ResultsOf the 452 patients with OHCA enrolled in the J-PULSE-HYPO study, 431 were analyzed. NMB was used in 353 patients (81.9%). Multivariable logistic regression analysis revealed that NMB use was not independently associated with favorable outcomes [odds ratio (OR), 0.96; 95% confidence interval (CI), 0.42-2.18; p = .918)] or survival at discharge (OR, 0.83; 95% CI, 0.31-2.02; p = .688). After adjusting the covariates, the predicted probabilities did not reveal significant differences between NMB use and non-NMB use in the respective mean (95% CI) values for favorable neurological outcomes [53.6 (50.2-57.0) % vs. 58.0 (50.4-65.6) %, p = .304], and survival rates [77.1 (74.7-79.5) % vs. 75.8 (70.5-81.0) %, p = .647].ConclusionsThe NMB use during TTM was not associated with favorable neurological outcomes and survival rate in patients with OHCA.Copyright © 2020 Elsevier Inc. All rights reserved.

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