Anne-Laure Constant1,2, Nicolas Mongardon3,4,5, Quentin Morelot6,7,8, Nicolas Pichon9, David Grimaldi1, Lauriane Bordenave10, Alexis Soummer11, Bertrand Sauneuf12, Sybille Merceron1, Sylvie Ricome13, Benoit Misset14,15, Cedric Bruel14, David Schnell16, Julie Boisramé-Helms16,17, Etienne Dubuisson18, Jennifer Brunet12, Sigismond Lasocki19,20, Pierrick Cronier21, Belaid Bouhemad22, Serge Carreira23, Emmanuelle Begot9, Benoit Vandenbunder24, Gilles Dhonneur3,4, Philippe Jullien18, Matthieu Resche-Rigon6,7,8, Jean-Pierre Bedos1, Claire Montlahuc6,7,8, Stephane Legriel25,26,27. 1. Medical-Surgical Intensive Care Unit, Intensive Care Department, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France. 2. Department of Anesthesiology and Critical Care Medicine, Hôpital Européen Georges Pompidou, 75015, Paris, France. 3. Department of Anesthesiology and Surgical Intensive Care Units, Hôpital Henri Mondor, Assistance Publique des Hôpitaux de Paris, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France. 4. Faculté de médecine, Université Paris Est, 8 avenue du général Sarrail, 94000, Créteil, France. 5. Inserm, U955, Equipe 3 "Stratégies pharmacologiques et thérapeutiques expérimentales des insuffisances cardiaques et coronaires", 8 avenue du général Sarrail, Créteil, France. 6. SBIM Biostatistics and Medical information, Hôpital Saint-Louis, APHP, 1, avenue Claude Vellefaux, Paris, France. 7. Université Paris Diderot, Paris, France. 8. ECSTRA Team (Epidémiologie Clinique et Statistiques pour la Recherche en Santé), UMR 1153 INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France. 9. Medical-Surgical Intensive Care Unit, Centre Hospitalier Universitaire de Limoges, 2, avenue Martin-Luther-King, 87042, Limoges, France. 10. Department of Anesthesiology, Institut Gustave Roussy, 39, rue Camille-Desmoulins, 94805, Villejuif Cedex, France. 11. Department of Intensive Care Medicine, Foch Hospital, 40 rue Worth, 92150, Suresnes, France. 12. Pôle Anesthésie-Réanimation-SAMU, CHU de Caen, Avenue de la côte de Nacre, CS30001, 14033, Caen Cedex 9, France. 13. Department of Anesthesiology and Critical Care, Assistance Publique des Hôpitaux de Paris, 100 boulevard du Général-Leclerc, 92110, Clichy la Garenne, France. 14. Medical-Surgical Intensive Care Unit, Groupe Hospitalier Saint Joseph, 185 rue Raymond Losserand, 75614, Paris Cedex, France. 15. Sorbonne Paris Cité-Medical School, Paris Descartes University, Paris, France. 16. Medical Intensive Care Unit, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. 17. EA 7293, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de médecine, Université de Strasbourg, Strasbourg, France. 18. Department of Anesthesiology, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France. 19. Pôle d'Anesthésie Réanimation, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex 9, Angers, France. 20. LUNAM Université, CHU d'Angers, 49933, Angers Cedex, France. 21. Intensive Care Unit, Centre Hospitalier Sud-Francilien, 116 boulevard Jean Jaurès, 91106, Corbeil-Essonnes Cedex, France. 22. Department of Anesthesiology and Critical Care, Groupe Hospitalier Saint Joseph, 185 rue Raymond Losserand, 75614, Paris Cedex, France. 23. Department of Intensive Care Medicine, Hôpital Saint-Camill, 2 rue des Pères-Camiliens, 94360, Bry-sur-Marne, France. 24. Department of Anesthesiology, Foch Hospital, 40 rue Worth, 92150, Suresnes, France. 25. Medical-Surgical Intensive Care Unit, Intensive Care Department, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France. slegriel@ch-versailles.fr. 26. Sorbonne Paris Cité-Medical School, Paris Descartes University, Paris, France. slegriel@ch-versailles.fr. 27. INSERM U970, Paris Cardiovascular Research Center, Paris, France. slegriel@ch-versailles.fr.
Abstract
PURPOSE: Few outcome data are available about temperature management after intraoperative cardiac arrest (IOCA). We describe targeted temperature management (TTM) (32-34 °C) modalities, adverse events, and association with 1-year functional outcome in patients with IOCA. METHODS: Patients admitted to 11 ICUs after IOCA in 2008-2013 were studied retrospectively. The main outcome measure was 1-year functional outcome. RESULTS: Of the 101 patients [35 women and 66 men; median age, 62 years (interquartile range, 42-72)], 68 (67.3%) were ASA PS I to III and 57 (56.4%) had emergent surgery. First recorded rhythms were asystole in 44 (43.6%) patients, pulseless electrical activity in 36 (35.6%), and ventricular fibrillation/tachycardia in 20 (19.8%). Median times from collapse to cardiopulmonary resuscitation and return of spontaneous circulation (ROSC) were 0 min (0-0) and 10 min (4-20), respectively. The 30 (29.7%) patients who received TTM had an increased risk of infection (P = 0.005) but not of arrhythmia, bleeding, or metabolic/electrolyte disorders. By multivariate analysis, one or more defibrillation before ROSC was positively associated with a favorable functional outcome at 1-year (OR 3.06, 95% CI 1.05-8.95, P = 0.04) and emergency surgery was negatively associated with 1-year favorable functional outcome (OR 0.36; 95% CI 0.14-0.95, P = 0.038). TTM use was not independently associated with 1-year favorable outcome (OR 0.82; 95% CI 0.27-2.46, P = 0.72). CONCLUSIONS: TTM was used in less than one-third of patients after IOCA. TTM was associated with infection but not with bleeding or coronary events in this setting. TTM did not independently predict 1-year favorable functional outcome after IOCA in this study.
PURPOSE: Few outcome data are available about temperature management after intraoperative cardiac arrest (IOCA). We describe targeted temperature management (TTM) (32-34 °C) modalities, adverse events, and association with 1-year functional outcome in patients with IOCA. METHODS:Patients admitted to 11 ICUs after IOCA in 2008-2013 were studied retrospectively. The main outcome measure was 1-year functional outcome. RESULTS: Of the 101 patients [35 women and 66 men; median age, 62 years (interquartile range, 42-72)], 68 (67.3%) were ASA PS I to III and 57 (56.4%) had emergent surgery. First recorded rhythms were asystole in 44 (43.6%) patients, pulseless electrical activity in 36 (35.6%), and ventricular fibrillation/tachycardia in 20 (19.8%). Median times from collapse to cardiopulmonary resuscitation and return of spontaneous circulation (ROSC) were 0 min (0-0) and 10 min (4-20), respectively. The 30 (29.7%) patients who received TTM had an increased risk of infection (P = 0.005) but not of arrhythmia, bleeding, or metabolic/electrolyte disorders. By multivariate analysis, one or more defibrillation before ROSC was positively associated with a favorable functional outcome at 1-year (OR 3.06, 95% CI 1.05-8.95, P = 0.04) and emergency surgery was negatively associated with 1-year favorable functional outcome (OR 0.36; 95% CI 0.14-0.95, P = 0.038). TTM use was not independently associated with 1-year favorable outcome (OR 0.82; 95% CI 0.27-2.46, P = 0.72). CONCLUSIONS: TTM was used in less than one-third of patients after IOCA. TTM was associated with infection but not with bleeding or coronary events in this setting. TTM did not independently predict 1-year favorable functional outcome after IOCA in this study.
Authors: Nicola Gasparetto; Daniele Scarpa; Sandra Rossi; Paolo Persona; Luigi Martano; Andrea Bianchin; Carlo Alberto Castioni; Carlo Ori; Sabino Iliceto; Luisa Cacciavillani Journal: Resuscitation Date: 2013-12-01 Impact factor: 5.262
Authors: Y Kawashima; S Takahashi; M Suzuki; K Morita; K Irita; Y Iwao; N Seo; K Tsuzaki; S Dohi; T Kobayashi; Y Goto; G Suzuki; A Fujii; H Suzuki; K Yokoyama; T Kugimiya Journal: Acta Anaesthesiol Scand Date: 2003-08 Impact factor: 2.105
Authors: Stéphane Legriel; Fabrice Bruneel; Haouaria Sediri; Julia Hilly; Nathalie Abbosh; Matthieu Henry Lagarrigue; Gilles Troche; Pierre Guezennec; Fernando Pico; Jean Pierre Bedos Journal: Neurocrit Care Date: 2009-12 Impact factor: 3.210