{"id":22396,"date":"2022-09-11T05:20:00","date_gmt":"2022-09-10T21:20:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=22396"},"modified":"2022-09-11T08:28:05","modified_gmt":"2022-09-11T00:28:05","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e9%99%a2%e5%86%85%e5%bf%83%e8%b7%b3%e9%aa%a4%e5%81%9c%e5%90%8e%e7%9b%ae%e6%a0%87%e4%bd%93%e6%b8%a9%e7%ae%a1%e7%90%86","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=22396","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u9662\u5185\u5fc3\u8df3\u9aa4\u505c\u540e\u76ee\u6807\u4f53\u6e29\u7ba1\u7406"},"content":{"rendered":"\n

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 162, ISSUE 2<\/a>, P356-366, AUGUST 01, 2022<\/p>\n\n\n\n

Targeted Temperature Management After In-Hospital Cardiac Arrest: An Ancillary Analysis of Targeted Temperature Management for Cardiac Arrest With Nonshockable Rhythm Trial Data<\/h1>\n\n\n\n

Alexiane Blanc, Gwenhael Colin, Alain Cariou, et al<\/h3>\n\n\n\n

Chest 2022; 162: 356-366 Published:March 19, 2022<\/h3>\n\n\n\n

DOI:https:\/\/doi.org\/10.1016\/j.chest.2022.02.056<\/a><\/h3>\n\n\n\n

Background<\/h3>\n\n\n\n

Targeted temperature management (TTM) currently is the only treatment with demonstrated efficacy in attenuating the harmful effects on the brain of ischemia-reperfusion injury after cardiac arrest. However, whether TTM is beneficial in the subset of patients with in-hospital cardiac arrest (IHCA) remains unclear.<\/p>\n\n\n\n

Research Question<\/h3>\n\n\n\n

Is TTM at 33 \u00b0C associated with better neurological outcomes after IHCA in a nonshockable rhythm compared with targeted normothermia (TN; 37 \u00b0C)?<\/p>\n\n\n\n

Study Design and Methods<\/h3>\n\n\n\n

We performed a post hoc analysis of data from the published Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm randomized controlled trial in 584 patients. We included the 159 patients with IHCA; 73 were randomized to 33 \u00b0C treatment and 86 were randomized to 37 \u00b0C treatment. The primary outcome was survival with a good neurologic outcome (cerebral performance category [CPC] score of 1 or 2) on day 90. Mixed multivariate adjusted logistic regression analysis was performed to determine whether survival with CPC score of 1 or 2 on day 90 was associated with type of temperature management after adjustment on baseline characteristics not balanced by randomization.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

Compared with TN for 48 h, hypothermia at 33 \u00b0C for 24 h was associated with a higher percentage of patients who were alive with good neurologic outcomes on day 90 (16.4% vs 5.8%; P = .<\/em>03). Day 90 mortality was not significantly different between the two groups (68.5% vs 76.7%; P = .<\/em>24). By mixed multivariate analysis adjusted by Cardiac Arrest Hospital Prognosis score and circulatory shock status, hypothermia was associated significantly with good day 90 neurologic outcomes (OR, 2.40 [95% CI, 1.17-13.03]; P = .<\/em>03).<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

Hypothermia at 33 \u00b0C was associated with better day 90 neurologic outcomes after IHCA in a nonshockable rhythm compared with TN. However, the limited sample size resulted in wide CIs. Further studies of patients after cardiac arrest resulting from any cause, including IHCA, are needed.<\/p>\n","protected":false},"excerpt":{"rendered":"

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 162, ISSU […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22396"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=22396"}],"version-history":[{"count":3,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22396\/revisions"}],"predecessor-version":[{"id":22621,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22396\/revisions\/22621"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=22396"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=22396"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=22396"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}