Association of Initial Illness Severity and Outcomes After Cardiac Arrest With Targeted Temperature Management at 36 °C or 33 °C | Zendy

Clifton W. Callaway | Zendy; Patrick J. Coppler | Zendy; John Faro | Zendy; Jacob S. Puyana | Zendy; Pawan Solanki | Zendy; Cameron Dezfulian | Zendy; Ankur Doshi | Zendy; Jonathan Elmer | Zendy; Adam Frisch | Zendy; Francis X. Guyette | Zendy; Masashi Okubo | Zendy; Jon C. Rittenberger | Zendy; Alexandra Weissman | Zendy

Open Access

Association of Initial Illness Severity and Outcomes After Cardiac Arrest With Targeted Temperature Management at 36 °C or 33 °C

Author(s) -

Clifton W. Callaway,

Patrick J. Coppler,

John Faro,

Jacob S. Puyana,

Pawan Solanki,

Cameron Dezfulian,

Ankur Doshi,

Jonathan Elmer,

Adam Frisch,

Francis X. Guyette,

Masashi Okubo,

Jon C. Rittenberger,

Alexandra Weissman

Publication year - 2020

Publication title -

jama network open

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.278

H-Index - 39

ISSN - 2574-3805

DOI - 10.1001/jamanetworkopen.2020.8215

Subject(s) - interquartile range , targeted temperature management , medicine , coma (optics) , cardiology , resuscitation , cohort , illness severity , glasgow coma scale , severity of illness , anesthesia , cardiopulmonary resuscitation , physics , optics , return of spontaneous circulation

Key Points Question What is the optimal target temperature for targeted temperature management (TTM) in comatose patients after cardiac arrest? Findings In a cohort study of 1319 patients, of whom 911 did not have severe cerebral edema or highly malignant electroencephalogram, TTM at 33 °C was associated with better survival than TTM at 36 °C for patients with the most severe post–cardiac arrest illness, but TTM at 36 °C was associated with better survival in patients with mild- to moderate-severity illness. Patients with severe cerebral edema or highly malignant electroencephalogram had poor outcomes regardless of TTM strategy. Meaning The findings of this study suggest that measuring initial illness severity in patients resuscitated from cardiac arrest may guide selection of the optimal TTM strategy.

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