Optimal Timing of Targeted Temperature Management for Post-Cardiac Arrest Syndrome: Is Sooner Better?

Targeted temperature management (TTM) is often considered to improve post-cardiac arrest patients’ outcomes. However, the optimal timing to initiate cooling remained uncertain. This retrospective analysis enrolled all non-traumatic post-cardiac arrest adult patients with either out-of-hospital cardi...
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Autor*in:	I-Ting Wang [verfasserIn] Chieh-Jen Wang [verfasserIn] Chao-Hsien Chen [verfasserIn] Sheng-Hsiung Yang [verfasserIn] Chun-Yen Chen [verfasserIn] Yen-Chun Huang [verfasserIn] Chang-Yi Lin [verfasserIn] Chien-Liang Wu [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	in-hospital cardiac arrest out-of-hospital cardiac arrest postcardiac arrest syndrome targeted temperature management timing

Übergeordnetes Werk:	In: Journal of Clinical Medicine - MDPI AG, 2013, 12(2023), 7, p 2628
Übergeordnetes Werk:	volume:12 ; year:2023 ; number:7, p 2628

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3390/jcm12072628

Katalog-ID:	DOAJ089366980

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author	I-Ting Wang
spellingShingle	I-Ting Wang misc in-hospital cardiac arrest misc out-of-hospital cardiac arrest misc postcardiac arrest syndrome misc targeted temperature management misc timing misc Medicine misc R Optimal Timing of Targeted Temperature Management for Post-Cardiac Arrest Syndrome: Is Sooner Better?
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topic_title	Optimal Timing of Targeted Temperature Management for Post-Cardiac Arrest Syndrome: Is Sooner Better? in-hospital cardiac arrest out-of-hospital cardiac arrest postcardiac arrest syndrome targeted temperature management timing
topic	misc in-hospital cardiac arrest misc out-of-hospital cardiac arrest misc postcardiac arrest syndrome misc targeted temperature management misc timing misc Medicine misc R
topic_unstemmed	misc in-hospital cardiac arrest misc out-of-hospital cardiac arrest misc postcardiac arrest syndrome misc targeted temperature management misc timing misc Medicine misc R
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title	Optimal Timing of Targeted Temperature Management for Post-Cardiac Arrest Syndrome: Is Sooner Better?
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title_full	Optimal Timing of Targeted Temperature Management for Post-Cardiac Arrest Syndrome: Is Sooner Better?
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title_sort	optimal timing of targeted temperature management for post-cardiac arrest syndrome: is sooner better?
title_auth	Optimal Timing of Targeted Temperature Management for Post-Cardiac Arrest Syndrome: Is Sooner Better?
abstract	Targeted temperature management (TTM) is often considered to improve post-cardiac arrest patients’ outcomes. However, the optimal timing to initiate cooling remained uncertain. This retrospective analysis enrolled all non-traumatic post-cardiac arrest adult patients with either out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA) who received TTM from July 2015 to July 2021 at our hospital. The values of time delay before TTM and time to target temperature were divided into three periods according to optimal cut-off values identified using receiver operating characteristic curve analysis. A total of 177 patients were enrolled. A shorter time delay before TTM (pre-induction time) was associated with a lower survival chance at 28 days (32.00% vs. 54.00%, <i<p</i< = 0.0279). Patients with a longer cooling induction time (<440 minis) had better neurological outcomes (1.58% vs. 1.05%; <i<p</i< = 0.001) and survival at 28 days (58.06% vs. 29.25%; <i<p</i< = 0.006). After COX regression analysis, the influence of pre-induction time on survival became insignificant, but patients who cooled slowest still had a better chance of survival at 28 days. In conclusion, a shorter delay before TTM was not associated with better clinical outcomes. However, patients who took longer to reach the target temperature had better hospital survival and neurological outcomes than those who were cooled more rapidly. A further prospective study was warranted to evaluate the appropriate time window of TTM.
abstractGer	Targeted temperature management (TTM) is often considered to improve post-cardiac arrest patients’ outcomes. However, the optimal timing to initiate cooling remained uncertain. This retrospective analysis enrolled all non-traumatic post-cardiac arrest adult patients with either out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA) who received TTM from July 2015 to July 2021 at our hospital. The values of time delay before TTM and time to target temperature were divided into three periods according to optimal cut-off values identified using receiver operating characteristic curve analysis. A total of 177 patients were enrolled. A shorter time delay before TTM (pre-induction time) was associated with a lower survival chance at 28 days (32.00% vs. 54.00%, <i<p</i< = 0.0279). Patients with a longer cooling induction time (<440 minis) had better neurological outcomes (1.58% vs. 1.05%; <i<p</i< = 0.001) and survival at 28 days (58.06% vs. 29.25%; <i<p</i< = 0.006). After COX regression analysis, the influence of pre-induction time on survival became insignificant, but patients who cooled slowest still had a better chance of survival at 28 days. In conclusion, a shorter delay before TTM was not associated with better clinical outcomes. However, patients who took longer to reach the target temperature had better hospital survival and neurological outcomes than those who were cooled more rapidly. A further prospective study was warranted to evaluate the appropriate time window of TTM.
abstract_unstemmed	Targeted temperature management (TTM) is often considered to improve post-cardiac arrest patients’ outcomes. However, the optimal timing to initiate cooling remained uncertain. This retrospective analysis enrolled all non-traumatic post-cardiac arrest adult patients with either out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA) who received TTM from July 2015 to July 2021 at our hospital. The values of time delay before TTM and time to target temperature were divided into three periods according to optimal cut-off values identified using receiver operating characteristic curve analysis. A total of 177 patients were enrolled. A shorter time delay before TTM (pre-induction time) was associated with a lower survival chance at 28 days (32.00% vs. 54.00%, <i<p</i< = 0.0279). Patients with a longer cooling induction time (<440 minis) had better neurological outcomes (1.58% vs. 1.05%; <i<p</i< = 0.001) and survival at 28 days (58.06% vs. 29.25%; <i<p</i< = 0.006). After COX regression analysis, the influence of pre-induction time on survival became insignificant, but patients who cooled slowest still had a better chance of survival at 28 days. In conclusion, a shorter delay before TTM was not associated with better clinical outcomes. However, patients who took longer to reach the target temperature had better hospital survival and neurological outcomes than those who were cooled more rapidly. A further prospective study was warranted to evaluate the appropriate time window of TTM.
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title_short	Optimal Timing of Targeted Temperature Management for Post-Cardiac Arrest Syndrome: Is Sooner Better?
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up_date	2024-07-03T22:42:49.186Z
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After COX regression analysis, the influence of pre-induction time on survival became insignificant, but patients who cooled slowest still had a better chance of survival at 28 days. In conclusion, a shorter delay before TTM was not associated with better clinical outcomes. However, patients who took longer to reach the target temperature had better hospital survival and neurological outcomes than those who were cooled more rapidly. 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