M Gorecka1, A Hanley2, F Burke3, P Nolan2, J Crowley2. 1. Cardiology Department, University College Hospital Galway, Galway, Ireland. miragorecka791@gmail.com. 2. Cardiology Department, University College Hospital Galway, Galway, Ireland. 3. Intensive Care Unit, University College Hospital Galway, Galway, Ireland.
Abstract
PURPOSE: The majority of cardiac arrests occur due to cardiovascular etiology. Targeted temperature management (TTM) (32-34 °C) is a part of the standard post arrest care. We hypothesized that lower body temperature may lead to reduced cardiac metabolic demand and potentially have a beneficial effect on myocardial function. METHODS: We performed a retrospective study on patients admitted to the intensive care unit following cardiac arrest secondary to cardiovascular etiology over a 9 year period. We assessed the impact of TTM on neurological and cardiac outcomes. RESULTS: There were 57 patients in the cohort; 21 patients in the TTM group and 36 in the non-TTM group. Demographic characteristics were similar in both groups-the majority of patients (86 vs 80 %, respectively) were males in their 60s. Neurological outcomes were similar; 24 % of patients died during the ICU admission in the TTM group vs 18 % in the non-TTM group. Mean GCS on admission to the ICU was 4 vs 7, respectively, and 11 at discharge in both groups. Majority of patients recovered good neurological function (GCS ≥ 13)-57 % in the TTM group vs 64 % in the non-TTM group. The change in left ventricular function over a 6 month follow up period was significantly better in patients who received targeted temperature management-mean change of +4.4 vs -3.3 %, respectively. This proved to be statistically significant (p = 0.02). CONCLUSIONS: The study demonstrates a possible beneficial effect of TTM on long-term cardiac function, when instituted following cardiac arrest.
PURPOSE: The majority of cardiac arrests occur due to cardiovascular etiology. Targeted temperature management (TTM) (32-34 °C) is a part of the standard post arrest care. We hypothesized that lower body temperature may lead to reduced cardiac metabolic demand and potentially have a beneficial effect on myocardial function. METHODS: We performed a retrospective study on patients admitted to the intensive care unit following cardiac arrest secondary to cardiovascular etiology over a 9 year period. We assessed the impact of TTM on neurological and cardiac outcomes. RESULTS: There were 57 patients in the cohort; 21 patients in the TTM group and 36 in the non-TTM group. Demographic characteristics were similar in both groups-the majority of patients (86 vs 80 %, respectively) were males in their 60s. Neurological outcomes were similar; 24 % of patients died during the ICU admission in the TTM group vs 18 % in the non-TTM group. Mean GCS on admission to the ICU was 4 vs 7, respectively, and 11 at discharge in both groups. Majority of patients recovered good neurological function (GCS ≥ 13)-57 % in the TTM group vs 64 % in the non-TTM group. The change in left ventricular function over a 6 month follow up period was significantly better in patients who received targeted temperature management-mean change of +4.4 vs -3.3 %, respectively. This proved to be statistically significant (p = 0.02). CONCLUSIONS: The study demonstrates a possible beneficial effect of TTM on long-term cardiac function, when instituted following cardiac arrest.
Authors: Mary Ann Peberdy; Clifton W Callaway; Robert W Neumar; Romergryko G Geocadin; Janice L Zimmerman; Michael Donnino; Andrea Gabrielli; Scott M Silvers; Arno L Zaritsky; Raina Merchant; Terry L Vanden Hoek; Steven L Kronick Journal: Circulation Date: 2010-11-02 Impact factor: 29.690
Authors: Niklas Nielsen; Jørn Wetterslev; Tobias Cronberg; David Erlinge; Yvan Gasche; Christian Hassager; Janneke Horn; Jan Hovdenes; Jesper Kjaergaard; Michael Kuiper; Tommaso Pellis; Pascal Stammet; Michael Wanscher; Matt P Wise; Anders Åneman; Nawaf Al-Subaie; Søren Boesgaard; John Bro-Jeppesen; Iole Brunetti; Jan Frederik Bugge; Christopher D Hingston; Nicole P Juffermans; Matty Koopmans; Lars Køber; Jørund Langørgen; Gisela Lilja; Jacob Eifer Møller; Malin Rundgren; Christian Rylander; Ondrej Smid; Christophe Werer; Per Winkel; Hans Friberg Journal: N Engl J Med Date: 2013-11-17 Impact factor: 91.245
Authors: Sebastian Wolfrum; Christian Pierau; Peter W Radke; Heribert Schunkert; Volkhard Kurowski Journal: Crit Care Med Date: 2008-06 Impact factor: 7.598