التفاصيل البيبلوغرافية
| العنوان: |
Targeted temperature management after intraoperative cardiac arrest: a multicenter retrospective study. |
| المؤلفون: |
Constant, Anne-Laure, Mongardon, Nicolas, Morelot, Quentin, Pichon, Nicolas, Grimaldi, David, Bordenave, Lauriane, Soummer, Alexis, Sauneuf, Bertrand, Merceron, Sybille, Ricome, Sylvie, Misset, Benoit, Bruel, Cedric, Schnell, David, Boisramé-Helms, Julie, Dubuisson, Etienne, Brunet, Jennifer, Lasocki, Sigismond, Cronier, Pierrick, Bouhemad, Belaid, Carreira, Serge |
| المصدر: |
Intensive Care Medicine; Apr2017, Vol. 43 Issue 4, p485-495, 11p |
| مصطلحات موضوعية: |
CARDIAC arrest, BODY temperature regulation, INTRAOPERATIVE care, HYPOTHERMIA, INDUCED hypothermia, CARDIOPULMONARY resuscitation, PREVENTION, THERAPEUTICS, TREATMENT of surgical complications, BODY temperature, COMPARATIVE studies, ELECTRIC countershock, INTENSIVE care units, RESEARCH methodology, MEDICAL cooperation, MULTIVARIATE analysis, RESEARCH, SURGICAL complications, TIME, EVALUATION research, TREATMENT effectiveness, PROPORTIONAL hazards models, RETROSPECTIVE studies |
| مصطلحات جغرافية: |
FRANCE |
| مستخلص: |
Purpose: Few outcome data are available about temperature management after intraoperative cardiac arrest (IOCA). We describe targeted temperature management (TTM) (32-34 °C) modalities, adverse events, and association with 1-year functional outcome in patients with IOCA.Methods: Patients admitted to 11 ICUs after IOCA in 2008-2013 were studied retrospectively. The main outcome measure was 1-year functional outcome.Results: Of the 101 patients [35 women and 66 men; median age, 62 years (interquartile range, 42-72)], 68 (67.3%) were ASA PS I to III and 57 (56.4%) had emergent surgery. First recorded rhythms were asystole in 44 (43.6%) patients, pulseless electrical activity in 36 (35.6%), and ventricular fibrillation/tachycardia in 20 (19.8%). Median times from collapse to cardiopulmonary resuscitation and return of spontaneous circulation (ROSC) were 0 min (0-0) and 10 min (4-20), respectively. The 30 (29.7%) patients who received TTM had an increased risk of infection (P = 0.005) but not of arrhythmia, bleeding, or metabolic/electrolyte disorders. By multivariate analysis, one or more defibrillation before ROSC was positively associated with a favorable functional outcome at 1-year (OR 3.06, 95% CI 1.05-8.95, P = 0.04) and emergency surgery was negatively associated with 1-year favorable functional outcome (OR 0.36; 95% CI 0.14-0.95, P = 0.038). TTM use was not independently associated with 1-year favorable outcome (OR 0.82; 95% CI 0.27-2.46, P = 0.72).Conclusions: TTM was used in less than one-third of patients after IOCA. TTM was associated with infection but not with bleeding or coronary events in this setting. TTM did not independently predict 1-year favorable functional outcome after IOCA in this study. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
