{"id":24407,"date":"2023-08-19T04:44:00","date_gmt":"2023-08-18T20:44:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24407"},"modified":"2023-08-19T05:27:12","modified_gmt":"2023-08-18T21:27:12","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%bf%83%e8%b7%b3%e9%aa%a4%e5%81%9c%e5%90%8e%e6%a0%b9%e6%8d%ae%e7%96%be%e7%97%85%e5%88%9d%e5%a7%8b%e4%b8%a5%e9%87%8d%e7%a8%8b%e5%ba%a6%e8%bf%9b","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24407","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u5fc3\u8df3\u9aa4\u505c\u540e\u6839\u636e\u75be\u75c5\u521d\u59cb\u4e25\u91cd\u7a0b\u5ea6\u8fdb\u884c\u76ee\u6807\u6027\u4f53\u6e29\u7ba1\u7406\u7684\u6548\u679c"},"content":{"rendered":"\n

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 163, ISSUE 5<\/a>, P1120-1129, MAY 2023Download Full Issue<\/p>\n\n\n\n

Differential Effect of Targeted Temperature Management Between 32 \u00b0C and 36 \u00b0C Following Cardiac Arrest According to Initial Severity of Illness: Insights From Two International Data Sets<\/h1>\n\n\n\n

Jean Baptiste Lascarrou, Florence Dumas, Wulfran Bougouin, et al<\/h3>\n\n\n\n

Chest 2023; 163: 1120-1129 Published:October 29, 2022<\/h3>\n\n\n\n

DOI:https:\/\/doi.org\/10.1016\/j.chest.2022.10.023<\/a><\/h3>\n\n\n\n

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

Recent guidelines have emphasized actively avoiding fever to improve outcomes in patients who are comatose following resuscitation from cardiac arrest (ie, out-of-hospital cardiac arrest). However, whether targeted temperature management between 32 \u00b0C and 36 \u00b0C (TTM32-36) can improve neurologic outcome in some patients remains debated.<\/p>\n\n\n\n

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

Is there an association between the use of TTM32-36 and outcome according to severity assessed at ICU admission using a previously derived risk score?<\/p>\n\n\n\n

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

Data prospectively collected in the Sudden Death Expertise Center (SDEC) registry (France) between May 2011 and December 2017 and in the Resuscitation Outcomes Consortium Continuous Chest Compressions (ROC-CCC) trial (United States and Canada) between June 2011 and May 2015 were used for this study. Severity at ICU admission was assessed through a modified version of the Cardiac Arrest Hospital Prognosis (mCAHP) score, divided into tertiles of severity. The study explored associations between TTM32-36 and favorable neurologic status at hospital discharge by using multiple logistic regression as well as in tertiles of severity for each data set.<\/p>\n\n\n\n

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

A total of 2,723 patients were analyzed in the SDEC data set and 4,202 patients in the ROC-CCC data set. A favorable neurologic status at hospital discharge occurred in 728 (27%) patients in the French data set and in 1,239 (29%) patients in the North American data set. Among the French data set, TTM32-36 was independently associated with better neurologic outcome in the tertile of patients with low (adjusted OR, 1.63; 95%\u00a0CI, 1.15-2.30;\u00a0P<\/em>\u00a0= .006) and high (adjusted OR, 1.94; 95%\u00a0CI, 1.06-3.54;\u00a0P<\/em>\u00a0= .030) severity according to mCAHP at ICU admission. Similar results were observed in the North American data set (adjusted ORs of 1.36 [95%\u00a0CI, 1.05-1.75;\u00a0P<\/em>\u00a0= .020] and 2.42 [95%\u00a0CI, 1.38-4.24;\u00a0P<\/em>\u00a0= .002], respectively). No association was observed between TTM32-36 and outcome in the moderate groups of the two data sets.<\/p>\n\n\n\n

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

TTM32-36 was significantly associated with a better outcome in patients with low and high severity at ICU admission assessed according to the mCAHP score. Further studies are needed to evaluate individualized temperature control following out-of-hospital cardiac arrest.<\/p>\n","protected":false},"excerpt":{"rendered":"

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 163, ISSU […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24407"}],"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=24407"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24407\/revisions"}],"predecessor-version":[{"id":24408,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24407\/revisions\/24408"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24407"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24407"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24407"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}