A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Severe or critical hypotension during post cardiac arrest care is associated with factors available on admission - a post hoc analysis of the TTH48 trial
Tekijät: 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
Kustantaja: W B SAUNDERS CO-ELSEVIER INC
Julkaisuvuosi: 2021
Journal: Journal of Critical Care
Tietokannassa oleva lehden nimi: JOURNAL OF CRITICAL CARE
Lehden akronyymi: J CRIT CARE
Vuosikerta: 61
Aloitussivu: 186
Lopetussivu: 190
Sivujen määrä: 5
ISSN: 0883-9441
eISSN: 1557-8615
DOI: https://doi.org/10.1016/j.jcrc.2020.10.026
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.
