Temperature variability during targeted temperature management is not associated with neurological outcomes following cardiac arrest.

Nayeri A, Bhatia N, Holmes B, Borges N, Armstrong W, Xu M, Farber-Eger E, Wells QS, McPherson JA
Am J Emerg Med. 2017 35 (6): 889-892

PMID: 28159373 · DOI:10.1016/j.ajem.2017.01.058

INTRODUCTION - Recent studies on comatose survivors of cardiac arrest undergoing targeted temperature management (TTM) have shown similar outcomes at multiple target temperatures. However, details regarding core temperature variability during TTM and its prognostic implications remain largely unknown. We sought to assess the association between core temperature variability and neurological outcomes in patients undergoing TTM following cardiac arrest.

METHODS - We analyzed a prospectively collected cohort of 242 patients treated with TTM following cardiac arrest at a tertiary care hospital between 2007 and 2014. Core temperature variability was defined as the statistical variance (i.e. standard deviation squared) amongst all core temperature recordings during the maintenance phase of TTM. Poor neurological outcome at hospital discharge, defined as a Cerebral Performance Category (CPC) score>2, was the primary outcome. Death prior to hospital discharge was assessed as the secondary outcome. Multivariable logistic regression was used to examine the association between temperature variability and neurological outcome or death at hospital discharge.

RESULTS - A poor neurological outcome was observed in 147 (61%) patients and 136 (56%) patients died prior to hospital discharge. In multivariable logistic regression, increased core temperature variability was not associated with increased odds of poor neurological outcomes (OR 0.38, 95% CI 0.11-1.38, p=0.142) or death (OR 0.43, 95% CI 0.12-1.53, p=0.193) at hospital discharge.

CONCLUSION - In this study, individual core temperature variability during TTM was not associated with poor neurological outcomes or death at hospital discharge.

Copyright © 2017 Elsevier Inc. All rights reserved.

MeSH Terms (16)

Aged Body Temperature Coma Female Fever Heart Arrest Humans Hypothermia, Induced Logistic Models Male Middle Aged Multivariate Analysis Patient Discharge Prospective Studies Tertiary Care Centers United States

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