• Josef Dankiewicz, Hans Friberg, Jan Bělohlávek, Andrew Walden, Christian Hassager, Tobias Cronberg, David Erlinge, Yvan Gasche, Jan Hovdenes, Janneke Horn, Jesper Kjaergaard, Michael Kuiper, Thomas Pellis, Pascal Stammet, Michael Wanscher, Jørn Wetterslev, Matthew Wise, Anders Åneman, and Niklas Nielsen.
• Department of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden. Electronic address: josef.dankiewicz@gmail.com.
• Resuscitation. 2016 Feb 1; 99: 44-9.

IntroductionThe optimal temperature during targeted temperature management (TTM) for comatose patients resuscitated from out-of-hospital cardiac arrest is unknown. It has been hypothesized that patients with long no-flow times, for example those without bystander CPR would have the most to gain from temperature management at lower temperatures.MethodsWe analysed data from an international clinical trial randomizing cardiac arrest patients to targeted temperature management at 33°C and 36°C for an interaction between no-flow time and intervention group, with neurological function at six months after cardiac arrest as the primary outcome. A cerebral performance category (CPC) score of 1 or 2 was considered a good outcome.ResultsNo-flow time (min) was associated with poor neurological outcome (OR 1.13, 95% confidence interval 1.06-1.20, p<0.001). There was no statistically significant interaction between no flow-time and intervention group (p=0.11), which may imply that the non-superior effect of 33°C was consistent for all no-flow times. Bystander CPR was not independently associated with neurological function.ConclusionsTTM at 33°C compared to 36°C was not associated with an increased probability of a good neurological function for patients with longer no-flow times.Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

14 keywords...

hide…