• Lijun Jiang, Yuan Bian, Weikang Liu, Wen Zheng, Jiaqi Zheng, Chuanbao Li, Ruijuan Lv, Yuhui Pan, Zhaolei Zheng, Mingjie Wang, Shaowei Sang, Chang Pan, Chunyi Wang, Rugang Liu, Kai Cheng, Jianbo Zhang, Jingjing Ma, Yuguo Chen, and Feng Xu.
• Shandong University Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.
• Shock. 2024 Feb 1; 61 (2): 204208204-208.

AbstractAims: Targeted temperature management is recommended for at least 24 h in comatose survivors of in-hospital cardiac arrest (IHCA) after the return of spontaneous circulation; however, whether an extension for 72 h leads to better neurological outcomes is uncertain. Methods: We included data from the Qilu Hospital of Shandong University between July 20, 2019, and June 30, 2022. Unconscious patients who had return of spontaneous circulation lasting >20 consecutive min and received endovascular cooling (72 h) or normothermia treatment were compared in terms of survival-to-discharge and favorable neurological survival. Propensity score matching was used to formulate balanced 1:3 matched patients. Results: In total, 2,084 patients were included. Sixteen patients received extended endovascular cooling and 48 matched controls received normothermia therapy. Compared with the normothermia group, patients who received prolonged endovascular cooling had a higher survival-to-discharge rate. However, good neurological outcomes did not differ significantly. Before matching, Cox regression analysis, using mortality as the event, showed that extended endovascular cooling independently affected the survival of IHCA patients. Conclusions: Among comatose patients who had been resuscitated from IHCA, the use of endovascular cooling for 72 h might confer a benefit on survival-to-discharge.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Shock Society.

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