Hovdenes Jan, Røysland Kjetil, Nielsen Niklas, Kjaergaard Jesper, Wanscher Michael, Hassager Christian, Wetterslev Jørn, Cronberg Tobias, Erlinge David, Friberg Hans, Gasche Yvan, Horn Janneke, Kuiper Michael, Pellis Tommaso, Stammet Pascal, Wise Matthew P, Åneman Anders, Bugge Jan Frederik
Department of Anesthesia and Intensive Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Department of Biostatistics, Institute of Basical Medical Sciences, University of Oslo, Norway.
Resuscitation. 2016 Oct;107:102-6. doi: 10.1016/j.resuscitation.2016.08.011. Epub 2016 Aug 23.
To investigate the association of temperature on arrival to hospital after out-of-hospital-cardiac arrest (OHCA) with the primary outcome of mortality, in the targeted temperature management (TTM) trial.
The TTM trial randomized 939 patients to TTM at 33 or 36°C for 24h. Patients were categorized according to their recorded body temperature on arrival and also categorized to groups of patients being actively cooled or passively rewarmed.
OHCA patients having a temperature ≤34.0°C on arrival at hospital had a significantly higher mortality compared to the OHCA patients with a higher temperature on arrival. A low body temperature on arrival was associated with a longer time to return of spontaneous circulation (ROSC) and duration of transport time to hospital. Patients who were actively cooled or passively rewarmed during the first 4h had similar mortality. In a multivariate logistic regression model mortality was significantly related to time from OHCA to ROSC, time from OHCA to advanced life support (ALS), age, sex and first registered rhythm. None of the temperature related variables (included the TTM-groups) were significantly related to mortality.
OHCA patients with a temperature ≤34.0°C on arrival have a higher mortality than patients with a temperature ≥34.1°C on arrival. A low temperature on arrival is associated with a long time to ROSC. Temperature changes and TTM-groups were not associated with mortality in a regression model.
在目标温度管理（TTM）试验中，研究院外心脏骤停（OHCA）后到达医院时的体温与死亡率这一主要结局之间的关联。
TTM试验将939例患者随机分为33℃或36℃的目标温度管理组，持续24小时。患者根据到达时记录的体温进行分类，同时也分为主动降温或被动复温的患者组。
与到达时体温较高的OHCA患者相比，到达医院时体温≤34.0℃的OHCA患者死亡率显著更高。到达时体温较低与自主循环恢复（ROSC）时间延长及送往医院的转运时间延长有关。在最初4小时内接受主动降温或被动复温的患者死亡率相似。在多变量逻辑回归模型中，死亡率与从OHCA到ROSC的时间、从OHCA到高级生命支持（ALS）的时间、年龄、性别及首次记录的心律显著相关。没有一个与温度相关的变量（包括TTM组）与死亡率显著相关。
到达时体温≤34.0℃的OHCA患者比到达时体温≥34.1℃的患者死亡率更高。到达时体温低与ROSC时间长有关。在回归模型中，温度变化和TTM组与死亡率无关。
Zotero 插件