A1 Journal article – refereed

Quality of targeted temperature management and outcome of out-of-hospital cardiac arrest patients: A post hoc analysis of the TTH48 study




List of Authors: De Fazio Chiara, Skrifvars Markus B, Søreide Eldar, Grejs Anders M., Di Bernardini Eugenio, Jeppesen Anni N., Storm Christian, Kjaergaard Jesper, Laitio Timo, Rasmussen Bodil S., Tianen Marjaana, Kirkegaard Hans, Taccone Fabio S.; on behalf of TTH48 Investigators

Publisher: ELSEVIER IRELAND LTD

Publication year: 2021

Journal: Resuscitation

Journal name in source: RESUSCITATION

Journal acronym: RESUSCITATION

Volume number: 165

Number of pages: 8

ISSN: 0300-9572

DOI: http://dx.doi.org/10.1016/j.resuscitation.2021.06.007


Abstract

Background: No data are available on the quality of targeted temperature management (TTM) provided to out-of-hospital cardiac arrest (OHCA) patients and its association with outcome.

Methods: Post hoc analysis of the TTH48 study (NCT01689077), which compared the effects of prolonged TTM at 33 degrees C for 48 h to standard 24-h TTM on neurologic outcome. Admission temperature, speed of cooling, rewarming rates, precision (i.e. temperature variability), overcooling and overshooting as post-cooling fever (i.e. >38.0 degrees C) were collected. A specific score, ranging from 1 to 9, was computed to define the "quality of TTM".

Results: On a total of 352 patients, most had a moderate quality of TTM (n = 217; 62% - score 4-6), while 80 (23%) patients had a low quality of TTM (score 1-3) and only 52 (16%) a high quality of TTM (score 7-9). The proportion of patients with unfavorable neurological outcome (UO; Cerebral Performance Category of 3-5 at 6 months) was similar between the different quality of TTM groups (p = 0.90). Although a shorter time from arrest to target temperature and a lower proportion of time outside the target ranges in the TTM 48-h than in the TTM 24-h group, quality of TTM was similar between groups. Also, the proportion of patients with UO was similar between the different quality of TTM groups when TTM 48-h and TTM 24-h were compared.

Conclusions: In this study, high quality of TTM was provided to a small proportion of patients. However, quality of TTM was not associated with patients' outcome.


Last updated on 2021-22-09 at 14:54