• Taro Irisawa, Tasuku Matsuyama, Taku Iwami, Tomoki Yamada, Koichi Hayakawa, Kazuhisa Yoshiya, Kazuo Noguchi, Tetsuro Nishimura, Toshifumi Uejima, Yoshiki Yagi, Takeyuki Kiguchi, Masafumi Kishimoto, Makoto Matsuura, Yasuyuki Hayashi, Taku Sogabe, Takaya Morooka, Tetsuhisa Kitamura, Takeshi Shimazu, and CRITICAL Study investigators.
• Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan. Electronic address: taroirisawa@gmail.com.
• Resuscitation. 2018 Dec 1; 133: 82-87.

BackgroundIt has been insufficiently investigated whether neurological function after out-of-hospital cardiac arrest (OHCA) would differ by 1 °C change in ordered target temperature of 33-36 °C among patients undergoing targeted temperature management (TTM) in the real-world setting.MethodsThis nationwide hospital-based observational study (The Japanese Association for Acute Medicine-OHCA Registry) conducted between June 2014 and December 2015 in Japan included OHCA patients aged ≥18 years who were treated with TTM. The primary outcome was one-month survival with neurologically favorable outcomes defined by cerebral performance category 1 or 2. To investigate the effect of TTM by 1 °C change in ordered target temperature of 33-36 °C on each outcome, random effects logistic regression analyses were performed.ResultsThe final analysis included 738 patients. The proportion of patients with neurologically favorable outcome was 30.4% (7/23), 31.7% (175/552), 28.9% (11/38), and 30.4% (38/125) in the 33 °C, 34 °C, 35 °C, and 36 °C groups, respectively. In the multivariable logistic regression analysis, no group had a higher proportion of neurologically favorable outcome compared with the 34 °C group (vs. 33 °C group, adjusted odds ratio [AOR] 0.90; 95% confidence interval [CI] 0.25-3.12, vs. 35 °C group, AOR 1.17; 95% CI 0.44-3.13, vs. 36 °C group, AOR 1.26; 95% CI 0.78-2.02).ConclusionsIn this population, we evaluated the difference in outcomes after adult OHCA patients received TTM by 1 °C change in ordered target temperature of 33-36 °C and demonstrated that there was no statistically significant difference in neurologically favorable outcomes after OHCA irrespective of target temperature.Copyright © 2018 Elsevier B.V. All rights reserved.

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