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Sep 16, 2019

ERC Congress 2019

5 - Comparison of the usefulness of a targeted temperature management protocol before and after modification: A single-centre retrospective study

targeted temperature management

protocol

35 degrees

Abstract

Abstract

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Keywords

targeted temperature management

protocol

35 degrees

Abstract

Background: After the targeted temperature management (TTM) trial in 2014, guidelines for cardiac arrest recommend maintaining a target temperature between 32°C and 36°C after return of spontaneous circulation (ROSC). We established an original TTM protocol that included maintaining a temperature of 35°C for our institute, as this temperature provides a large safety margin for temperature variation and is expected to reduce the comorbidity with TTM. This is a single-centre retrospective study that assessed the usefulness of the new 35°C TTM protocol in comparison with the conventional 34°C or 36°C protocol. Methods: Patients aged ≥18 years who were transported to a tertiary hospital in Tokyo from June 2014 to March 2019 were included. We compared the 35°C protocol cohort with the conventional protocol cohort in terms of performance rate, background factors (sex, age, witness of collapse, bystander cardiopulmonary resuscitation, initial rhythm, prehospital ROSC, transfer time, consciousness level, arterial blood gas measurements, cause of arrest, induction of extracorporeal circulation or intra-arterial balloon pumping, coronary angiography, and cooling method), and outcomes (incidence of comorbidity, time between ROSC and achievement of target temperature, and neurological outcome and survival 30 days after ROSC). Results: The performance rate of TTM was significantly higher in the 35°C protocol than in the conventional protocol (32.8% vs 16.7%). In comparison with the conventional protocol, the patients managed with the 35°C protocol had less shockable initial rhythm and lower pH just after hospital arrival among the background factors. Target temperatures did not independently affect either the mortality or neurological outcomes. There were no differences in the incidences of complications and time from ROSC between the target temperatures of the conventional and new protocols. Conclusion: The new 35°C protocol can be introduced more readily than the conventional protocol, without increasing comorbidity and mortality.

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© Copyright 2019 Morressier GmbH.
All rights reserved.