Mid-term clinical outcomes of out-of-hospital cardiac arrest patients treated with targeted temperature management at 34-36 degrees C versus 32-34 degrees C
Abstract
Background: Targeted temperature management (TTM) in comatose survivors of out-of-hospital cardiac arrest has been associated with improved neurological outcomes. However, the optimal temperature target for TTM remains unclear.
Objectives: To compare a TTM protocol targeted at 34-36 °C with a protocol targeted at 32-34 °C with reference to both clinical outcomes and acute complications. Methods: We analyzed a prospective registry of consecutive out-of-hospital cardiac arrest survivors who underwent TTM.
We compared patients on a TTM protocol targeted at 34-36 °C (n = 59) with a historical cohort of patients treated at 32-34 °C (n = 116) according to the following parameters: six-month survival, cerebral performance category (CPC) scores, and acute complications. Results: Survival and favorable neurological outcomes (CPC LESS-THAN OR EQUAL TO 2) at six months were 56% and 49%, respectively, in the higher target temperature group vs. 66% and 61%, respectively, in the lower target temperature group (p = 0.18 and 0.13).
Acute clinical complications occurred in 1.5% vs. 12% of patients treated at the higher vs. the lower temperature range (p = 0.02). Conclusions: Patients treated with TTM at 34-36 °C had similar mid-term survival and neurological outcomes as patients treated with TTM at 32-34 °C.
However, patients treated within the higher temperature range had fewer acute complications.