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Temporal trends in the use of targeted temperature management after cardiac arrest and association with outcome: insights from the Paris Sudden Death Expertise Centre
- Source :
- Critical care (London, England), vol 23, iss 1, Critical Care, Critical Care, BioMed Central, 2019, 23 (1), pp.391. ⟨10.1186/s13054-019-2677-1⟩, Critical Care, Vol 23, Iss 1, Pp 1-11 (2019)
- Publication Year :
- 2019
- Publisher :
- eScholarship, University of California, 2019.
-
Abstract
- Purpose Recent doubts regarding the efficacy may have resulted in a loss of interest for targeted temperature management (TTM) in comatose cardiac arrest (CA) patients, with uncertain consequences on outcome. We aimed to identify a change in TTM use and to assess the relationship between this change and neurological outcome. Methods We used Utstein data prospectively collected in the Sudden Death Expertise Center (SDEC) registry (capturing CA data from all secondary and tertiary hospitals located in the Great Paris area, France) between May 2011 and December 2017. All cases of non-traumatic OHCA patients with stable return of spontaneous circulation (ROSC) were included. After adjustment for potential confounders, we assessed the relationship between changes over time in the use of TTM and neurological recovery at discharge using the Cerebral Performance Categories (CPC) scale. Results Between May 2011 and December 2017, 3925 patients were retained in the analysis, of whom 1847 (47%) received TTM. The rate of good neurological outcome at discharge (CPC 1 or 2) was higher in TTM patients as compared with no TTM (33% vs 15%, P P P P P = 0.76). After adjustment, year of CA occurrence was not associated with outcome. Conclusions We report a progressive decrease in the use of TTM in post-cardiac arrest patients over the recent years. During this period, neurological outcome remained stable, despite an increase in bystander-initiated resuscitation and a decrease in “no flow” duration.
- Subjects :
- SDEC
Male
Resuscitation
Time Factors
Outcome Assessment
medicine.medical_treatment
Hypothermia
030204 cardiovascular system & hematology
Targeted temperature management
Cardiovascular
Critical Care and Intensive Care Medicine
Medical and Health Sciences
0302 clinical medicine
Hypothermia, Induced
Outcome Assessment, Health Care
Odds Ratio
80 and over
Medicine
Registries
Aged, 80 and over
Confounding
lcsh:Medical emergencies. Critical care. Intensive care. First aid
Middle Aged
Cardiac arrest
3. Good health
[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Neurological outcome
Heart Disease
Treatment Outcome
Female
Induced hypothermia
medicine.medical_specialty
Paris
and over
Return of spontaneous circulation
Sudden death
03 medical and health sciences
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Clinical Research
Internal medicine
Humans
Aged
business.industry
Research
Induced
Neurosciences
030208 emergency & critical care medicine
lcsh:RC86-88.9
Emergency & Critical Care Medicine
Brain Disorders
Health Care
Logistic Models
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
Bystander cpr
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
Out-of-Hospital Cardiac Arrest
Subjects
Details
- ISSN :
- 13648535 and 1466609X
- Database :
- OpenAIRE
- Journal :
- Critical care (London, England), vol 23, iss 1, Critical Care, Critical Care, BioMed Central, 2019, 23 (1), pp.391. ⟨10.1186/s13054-019-2677-1⟩, Critical Care, Vol 23, Iss 1, Pp 1-11 (2019)
- Accession number :
- edsair.doi.dedup.....726ee69868a81f0b9ad760952dd45fd6