Open AccessAssociation Between Target Temperature Variability and Neurologic Outcomes for Patients Receiving Targeted Temperature Management at 36°C After Cardiac Arrest: A Retrospective Cohort Study
Author(s) -
Makayla Cordoza,
Hilaire J. Thompson,
Elizabeth Bridges,
Robert L. Burr,
David Carlbom
Publication year - 2021
Publication title -
therapeutic hypothermia and temperature management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.323
H-Index - 12
eISSN - 2153-7933
pISSN - 2153-7658
DOI - 10.1089/ther.2020.0005
Subject(s) - targeted temperature management , medicine , odds ratio , retrospective cohort study , confidence interval , hypothermia , odds , cohort , cohort study , anesthesia , resuscitation , cardiopulmonary resuscitation , logistic regression , return of spontaneous circulation
Maintaining strict temperature control during the maintenance phase of targeted temperature management (TTM) after cardiac arrest may be an important component of clinical care. Temperature variability outside of the goal temperature range may lessen the benefit of TTM and worsen neurologic outcomes. The purpose of this retrospective study of 186 adult patients (70.4% males, mean age 53.8 ± 15.7 years) was to investigate the relationship between body temperature variability (at least one body temperature measurement outside of 36°C ± 0.5°C) during the maintenance phase of TTM at 36°C after cardiac arrest and neurologic outcome at hospital discharge. Patients with temperature variability ( n = 124 [66.7%]) did not have significantly higher odds of poor neurologic outcome compared with those with no temperature variability (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 0.36-2.82). Use of neuromuscular blocking agents (NMBAs) and having an initial shockable rhythm were associated with both higher odds of good neurologic outcome (shockable rhythm: OR = 10.77, 95% CI = 4.30-26.98; NMBA use: OR = 4.54, 95% CI = 1.34-15.40) and survival to hospital discharge (shockable rhythm: OR = 5.90, 95% CI = 2.65-13.13; NMBA use: OR = 3.03, 95% CI = 1.16-7.90). In this cohort of postcardiac arrest comatose survivors undergoing TTM at 36°C, having temperature variability during maintenance phase did not significantly impact neurologic outcome or survival.