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Association of time-temperature curves with outcomes in temperature management for cardiac arrest.

Publication ,  Journal Article
Luedke, MW; Graffagnino, C; McKinney, BG; Piper, J; Iversen, E; Kolls, B
Published in: BMJ Neurol Open
2022

BACKGROUND/PURPOSE: Cardiac arrest is a common cause of death and neurological injury; therapeutic cooling for neuroprotection is standard of care. Despite numerous and ongoing trials targeting a specified cooling temperature for a target duration, the concept of temperature dose-the duration spent at a given depth of hypothermia-is not as well explored. METHODS: In this retrospective study, we examined 66 patients 18 years of age or older undergoing therapeutic hypothermia for cardiac arrest between 2007 and 2010 to assess the relationship of temperature dose with outcomes. Demographic, clinical, outcome and temperature data were collected. Demographic and clinical data underwent bivariate regression analysis for association with outcome. Time-temperature curves were divided into pre-determined temperature thresholds and assessed by logistic regression analysis for association with outcome. A second, multivariate regression analysis was performed controlling for factors associated with poor outcomes. RESULTS: Old age was significantly associated with poor outcome and a shockable arrest rhythm was significantly associated with positive outcome. Subjects spent an average of 2.82 hours below 35°C, 7.31 hours ≥35°C to ≤36.5°C, 24.75 hours >36.5 to <38.0°C and 7.06 hours ≥38°C. Logistic regression analysis revealed borderline significant positive association between good outcome and time at a cooling depth (35°C-36.5°C, p=0.05); adjusted for old age, the association became significant (p=0.04). CONCLUSION: Controlling for old age, longer durations between >35°C, ≤36.5°C during therapeutic hypothermia for cardiac arrest were significantly associated with good clinical outcomes. Time spent within a given temperature range may be useful for measuring the effect of temperature management.

Duke Scholars

Published In

BMJ Neurol Open

DOI

EISSN

2632-6140

Publication Date

2022

Volume

4

Issue

1

Start / End Page

e000273

Location

England

Related Subject Headings

  • 4206 Public health
  • 3209 Neurosciences
 

Citation

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Chicago
ICMJE
MLA
NLM
Luedke, M. W., Graffagnino, C., McKinney, B. G., Piper, J., Iversen, E., & Kolls, B. (2022). Association of time-temperature curves with outcomes in temperature management for cardiac arrest. BMJ Neurol Open, 4(1), e000273. https://doi.org/10.1136/bmjno-2022-000273
Luedke, Matthew William, Carmelo Graffagnino, B Grace McKinney, Jill Piper, Edwin Iversen, and Brad Kolls. “Association of time-temperature curves with outcomes in temperature management for cardiac arrest.BMJ Neurol Open 4, no. 1 (2022): e000273. https://doi.org/10.1136/bmjno-2022-000273.
Luedke MW, Graffagnino C, McKinney BG, Piper J, Iversen E, Kolls B. Association of time-temperature curves with outcomes in temperature management for cardiac arrest. BMJ Neurol Open. 2022;4(1):e000273.
Luedke, Matthew William, et al. “Association of time-temperature curves with outcomes in temperature management for cardiac arrest.BMJ Neurol Open, vol. 4, no. 1, 2022, p. e000273. Pubmed, doi:10.1136/bmjno-2022-000273.
Luedke MW, Graffagnino C, McKinney BG, Piper J, Iversen E, Kolls B. Association of time-temperature curves with outcomes in temperature management for cardiac arrest. BMJ Neurol Open. 2022;4(1):e000273.

Published In

BMJ Neurol Open

DOI

EISSN

2632-6140

Publication Date

2022

Volume

4

Issue

1

Start / End Page

e000273

Location

England

Related Subject Headings

  • 4206 Public health
  • 3209 Neurosciences