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Regional cerebral oxygen saturation in cardiac arrest survivors undergoing targeted temperature management 36 °C versus 33 °C: A randomized clinical trial

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Author(s)
Woon Yong KwonYoon Sun JungGil Joon SuhTaekyun KimHyeongkyu KwakTaekwon KimJeong Yeon KimMin Sung LeeKyung Su KimJonghwan ShinHui Jai LeeKyung Min You
Keimyung Author(s)
Kim, Tae Kwon
Department
Dept. of Emergency Medicine (응급의학)
Journal Title
Resuscitation
Issued Date
2021
Volume
167
Keyword
BrainHypothermiaInducedNear-InfraredOut-of-hospital cardiac arrestOximetryPrognosisSpectroscopy
Abstract
Aim of study:
To investigate whether regional cerebral oxygen saturation (rSO 2 ) differs in out-of-hospital cardiac arrest (OHCA) survivors undergoing targeted temperature management (TTM) 36 °C versus 33 °C.

Methods:
A randomized clinical trial was conducted at intensive care units in two referral hospitals. Fifty-seven comatose OHCA survivors were randomized into either a 36 °C or 33 °C group. Patients were cooled and maintained at an oesophageal temperature of either 36 °C or 33 °C for 24 hours, rewarmed at a rate of 0.25 °C/hour, and maintained at <37.5 °C until 72 hours. During 72 hours of TTM, rSO 2 was continuously monitored on the left forehead using near-infrared spectroscopy (INVOS TM 5100C). The rSO 2 level at 72 hours was compared between the two groups. Next, serial rSO 2 levels for 72 hours were compared using mixed effects regression. The association between rSO 2 levels and 6-month neurological outcomes was also evaluated.

Results:
There were no significant differences in the rSO 2 level at 72 hours between the 36 °C and 33 °C groups ( p = 0.372). Furthermore, serial rSO 2 levels for 72 hours of TTM were not different between the two groups ( p = 0.733). However, low rSO 2 levels, particularly at 24 hours of TTM, were significantly associated with poor 6-month neurological outcomes (odds ratio = 0.899, 95% confidence interval: 0.831–0.974). The area under the receiver operating characteristic curve of the rSO 2 level at 24 hours for poor neurological outcomes was 0.800.

Conclusions:
Regardless of target temperatures, low rSO 2 levels during TTM were significantly associated with poor 6-month neurological outcomes in OHCA survivors.
Keimyung Author(s)(Kor)
김태권
Publisher
School of Medicine (의과대학)
Citation
Woon Yong Kwon et al. (2021). Regional cerebral oxygen saturation in cardiac arrest survivors undergoing targeted temperature management 36 °C versus 33 °C: A randomized clinical trial. Resuscitation, 167, 362–371. doi: 10.1016/j.resuscitation.2021.07.026
Type
Article
ISSN
0300-9572
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0300957221002781
DOI
10.1016/j.resuscitation.2021.07.026
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43980
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학)
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