Intravascular versus surface cooling for targeted temperature management after out-of-hospital cardiac arrest: an analysis of the TTH48 trial

Critical Care : the Official Journal of the Critical Care Forum
Chiara De FazioFabio Silvio Taccone

Abstract

The aim of this study was to explore the performance and outcomes for intravascular (IC) versus surface cooling devices (SFC) for targeted temperature management (TTM) after out-of-hospital cardiac arrest. A retrospective analysis of data from the Time-differentiated Therapeutic Hypothermia (TTH48) trial (NCT01689077), which compared whether TTM at 33 °C for 48 h results in better neurologic outcomes compared with standard 24-h duration. Devices were assessed for the speed of cooling and rewarming rates. Precision was assessed by measuring temperature variability (TV), i.e., the standard deviation (SD) of all temperature measurements in the cooling phase. Main outcomes were overall mortality and poor neurological outcome, including death, severe disability, or vegetative status. A total of 352 patients had available data and were included in the analysis; of those, 218 (62%) were managed with IC. A total of 114/218 (53%) patients with IC and 61/134 (43%) with SFC were cooled for 48 h (p = 0.22). Time to target temperature (≤ 34 °C) was significantly shorter for patients treated with endovascular devices (2.2 [1.1-4.0] vs. 4.2 [2.7-6.0] h, p < 0.001), but temperature was also lower on admission (35.0 [34.2-35.6] vs. 35.3 [34.5-3...Continue Reading

References

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Citations

Sep 19, 2019·Minerva anestesiologica·Edoardo PicettiSandra Rossi
May 6, 2020·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Melika HosseiniYama Akbari
Aug 25, 2019·Critical Care : the Official Journal of the Critical Care Forum·Lorenzo CalabróFabio Silvio Taccone
Dec 15, 2020·Annals of Intensive Care·Mathieu JozwiakAlain Cariou
Jun 1, 2021·Neurosurgery Clinics of North America·Aditya Vedantam, Allan D Levi

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Methods Mentioned

BETA
sedation

Clinical Trials Mentioned

NCT01689077

Software Mentioned

SPSS Statistics

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