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Speed of cooling after cardiac arrest in relation to the intervention effect: a sub-study from the TTM2-trial.
- Source :
- Critical Care; 11/15/2022, Vol. 26 Issue 1, p1-8, 8p
- Publication Year :
- 2022
-
Abstract
- <bold>Background: </bold>Targeted temperature management (TTM) is recommended following cardiac arrest; however, time to target temperature varies in clinical practice. We hypothesised the effects of a target temperature of 33 °C when compared to normothermia would differ based on average time to hypothermia and those patients achieving hypothermia fastest would have more favorable outcomes.<bold>Methods: </bold>In this post-hoc analysis of the TTM-2 trial, patients after out of hospital cardiac arrest were randomized to targeted hypothermia (33 °C), followed by controlled re-warming, or normothermia with early treatment of fever (body temperature, ≥ 37.8 °C). The average temperature at 4 h (240 min) after return of spontaneous circulation (ROSC) was calculated for participating sites. Primary outcome was death from any cause at 6 months. Secondary outcome was poor functional outcome at 6 months (score of 4-6 on modified Rankin scale).<bold>Results: </bold>A total of 1592 participants were evaluated for the primary outcome. We found no evidence of heterogeneity of intervention effect based on the average time to target temperature on mortality (p = 0.17). Of patients allocated to hypothermia at the fastest sites, 71 of 145 (49%) had died compared to 68 of 148 (46%) of the normothermia group (relative risk with hypothermia, 1.07; 95% confidence interval 0.84-1.36). Poor functional outcome was reported in 74/144 (51%) patients in the hypothermia group, and 75/147 (51%) patients in the normothermia group (relative risk with hypothermia 1.01 (95% CI 0.80-1.26).<bold>Conclusions: </bold>Using a hospital's average time to hypothermia did not significantly alter the effect of TTM of 33 °C compared to normothermia and early treatment of fever. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 13648535
- Volume :
- 26
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Critical Care
- Publication Type :
- Academic Journal
- Accession number :
- 160254425
- Full Text :
- https://doi.org/10.1186/s13054-022-04231-6