Cho Eunhye, Lee Sung Eun, Park Eunjung, Kim Hyuk-Hoon, Lee Ji Sook, Choi Sangchun, Min Young Gi, Chae Minjung Kathy
Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea.
Clin Exp Emerg Med. 2019 Mar;6(1):25-30. doi: 10.15441/ceem.17.275. Epub 2019 Feb 20.
Cerebral hemodynamic and metabolic changes may occur during the rewarming phase of targeted temperature management in post cardiac arrest patients. Yet, studies on different rewarming rates and patient outcomes are limited. This study aimed to investigate post cardiac arrest patients who were rewarmed with different rewarming rates after 24 hours of hypothermia and the association of these rates to the neurologic outcomes.
This study retrospectively investigated post cardiac arrest patients treated with targeted temperature management and rewarmed with rewarming rates of 0.15°C/hr and 0.25°C/hr. The association of the rewarming rate with poor neurologic outcomes (cerebral performance category score, 3 to 5) was investigated.
A total of 71 patients were analyzed (0.15°C/hr, n=36; 0.25°C/hr, n=35). In the comparison between 0.15°C/hr and 0.25°C/hr, the poor neurologic outcome did not significantly differ (24 [66.7%] vs. 25 [71.4%], respectively; P=0.66). In the multivariate analysis, the rewarming rate of 0.15°C/hr was not associated with the 1-month neurologic outcome improvement (odds ratio, 0.54; 95% confidence interval, 0.16 to 1.69; P=0.28).
The rewarming rates of 0.15°C/hr and 0.25°C/hr were not associated with the neurologic outcome difference in post cardiac arrest patients.
心脏骤停后患者进行目标温度管理复温阶段可能会发生脑血流动力学和代谢变化。然而,关于不同复温速率与患者预后的研究有限。本研究旨在调查心脏骤停后经24小时低温治疗后以不同复温速率复温的患者,以及这些速率与神经学预后的关联。
本研究回顾性调查了接受目标温度管理并分别以0.15℃/小时和0.25℃/小时的复温速率复温的心脏骤停后患者。研究了复温速率与不良神经学预后(脑功能分类评分3至5分)之间的关联。
共分析了71例患者(0.15℃/小时组,n = 36;0.25℃/小时组,n = 35)。在0.15℃/小时和0.25℃/小时组的比较中,不良神经学预后无显著差异(分别为24例[66.7%]和25例[71.4%];P = 0.66)。在多变量分析中,0.15℃/小时的复温速率与1个月时神经学预后改善无关(比值比,0.54;95%置信区间,0.16至1.69;P = 0.28)。
0.15℃/小时和0.25℃/小时的复温速率与心脏骤停后患者的神经学预后差异无关。