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Shorter Interval from Witnessed Out-Of-Hospital Cardiac Arrest to Reaching the Target Temperature Could Improve Neurological Outcomes After Extracorporeal Cardiopulmonary Resuscitation with Target Temperature Management: A Retrospective Analysis

By Currents Editor posted 12-24-2020 09:34

  

Shorter Interval from Witnessed Out-Of-Hospital Cardiac Arrest to Reaching the Target Temperature Could Improve Neurological Outcomes After Extracorporeal Cardiopulmonary Resuscitation with Target Temperature Management: A Retrospective Analysis of a Japanese Nationwide Multicenter Observational Registry

Therapeutic Hypothermia and Temperature Management (12/04/20) doi: 10.1089/ther.2020.0045
Yamada, Shu; Kaneko, Tadashi; Kitada, Maki; et al.
https://www.liebertpub.com/doi/10.1089/ther.2020.0045

 

For patients with witnessed out-of-hospital cardiac arrest, time to reach the target body temperature was a key factor in achieving favorable neurological outcomes. New research indicates significantly more favorable outcomes when the time to target temperature management (TTM) was 600 minutes or less. The study, which used retrospective subanalyses of the Japanese Association for Acute Medicine OHCA registry, examined the neurological outcomes of HCA between extracorporeal cardiopulmonary resuscitation (ECPR) and conventional cardiopulmonary resuscitation (CCPR) in all patients with target temperature management. Univariate and multivariable analyses were used to compare the neurological outcomes after ECPR or CCPR for 1,146 cases. Propensity score analyses were conducted according to the interval from witnessed OHCA to achieving the target temperature (IWT) of less than 600, 480, 360, 240, and 120 minutes. Based on the analysis, there was no meaningful difference in favorable neurological outcomes — a Glasgow–Pittsburgh Cerebral Performance Category of 1–2 at 1 month after collapse — between EPCR and CCPR. For patients with IWT of 600 minutes or less, however, ECPR was tied to more favorable outcomes compared with CCPR, the researchers concluded.

 

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