Severe or critical hypotension during post cardiac arrest care is associated with factors available on admission - a post hoc analysis of the TTH48 trial - UTU Research Portal

A1 Refereed original research article in a scientific journal

Severe or critical hypotension during post cardiac arrest care is associated with factors available on admission - a post hoc analysis of the TTH48 trial

Authors: Hästbacka Johanna, Kirkegaard Hans, Soreide Eldar, Taccone Fabio Silvio, Rasmussen Bodil Steen, Storm Christian, Kjaergaard Jesper, Laitio Timo, Duez Christophe Henri Valdemar, Jeppesen Anni N, Grejs Anders M, Skrifvars Markus B

Publisher: W B SAUNDERS CO-ELSEVIER INC

Publication year: 2021

Journal: Journal of Critical Care

Journal name in source: JOURNAL OF CRITICAL CARE

Journal acronym: J CRIT CARE

Volume: 61

First page : 186

Last page: 190

Number of pages: 5

ISSN: 0883-9441

eISSN: 1557-8615

DOI: https://doi.org/10.1016/j.jcrc.2020.10.026

Abstract

Purpose: We explored whether severe or critical hypotension can be predicted, based on patient and resuscitation characteristics in out-of-hospital cardiac arrest (OHCA) patients. We also explored the association of hypotension with mortality and neurological outcome.
Materials and methods: We conducted a post hoc analysis of the TTH48 study (NCT01689077), where 355 out-of-hospital cardiac arrest (OHCA) patients were randomized to targeted temperature management (TTM) treatment at 33 degrees C for either 24 or 48 h. We recorded hypotension, according to four severity categories, within four days from admission. We used multivariable logistic regression analysis to test association of admission data with severe or critical hypotension.
Results: Diabetes mellitus (OR 3.715, 95% CI 1.180-11.692), longer ROSC delay (OR 1.064, 95% CI 1.022-1.108), admission MAP (OR 0.960, 95% CI 0.929-0.991) and non-shockable rhythm (OR 5.307, 95% CI 1.604-17.557) were associated with severe or critical hypotension. Severe or critical hypotension was associated with increased mortality and poor neurological outcome at 6 months.
Conclusions: Diabetes, non-shockable rhythm, longer delay to ROSC and lower admission MAP were predictors of severe or critical hypotension. Severe or critical hypotension was associated with poor outcome. (C) 2020 Published by Elsevier Inc.