Clinical Outcomes with Targeted Temperature Management (TTM) in Comatose Out-of-Hospital Cardiac Arrest Patients-A Retrospective Cohort Study

• Published in: Journal of clinical medicine Vol. 11; no. 7; p. 1786
• Main Authors: Scholte, Niels T B, van Wees, Christiaan, Rietdijk, Wim J R, van der Graaf, Marisa, Jewbali, Lucia S D, van der Jagt, Mathieu, van den Berg, Remco C M, Lenzen, Mattie J, den Uil, Corstiaan A
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 24.03.2022; MDPI
• Subjects: Cardiac arrest; Clinical medicine; Clinical outcomes; Cohort analysis; Fever; Length of stay; Logistics; Mortality; Patients; Statistical analysis; Variables; mortality; out-of-hospital; cardiac arrest; targeted temperature management; intensive care units
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm11071786

Purpose: we evaluated the effects of the shift of a targeted temperature management (TTM) strategy from 33 °C to 36 °C in comatose out-of-hospital cardiac arrest (OHCA) patients admitted to the Intensive Care Unit (ICU). Methods: we performed a retrospective study of all comatose (GCS < 8) OHCA patients treated with TTM from 2010 to 2018 (n = 798) from a single-center academic hospital. We analyzed 90-day mortality, and neurological outcome (CPC score) at ICU discharge and ICU length of stay, as primary and secondary outcomes, respectively. Results: we included 798 OHCA patients (583 in the TTM33 group and 215 in the TTM36 group). We found no association between the TTM strategy (TTM33 and TTM36) and 90-day mortality (hazard ratio (HR)] 0.877, 95% CI 0.677−1.135, with TTM36 as reference). Also, no association was found between TTM strategy and favorable neurological outcome at ICU discharge (odds ratio (OR) 1.330, 95% CI 0.941−1.879). Patients in the TTM33 group had on average a longer ICU LOS (beta 1.180, 95% CI 0.222−2.138). Conclusion: no differences in clinical outcomes—both 90-day mortality and favorable neurological outcome at ICU discharge—were found between targeted temperature at 33 °C and 36 °C. These results may help to corroborate previous trial findings and assist in implementation of TTM.