Early onset pneumonia after successful resuscitation : Incidence after mild invasive hypothermia therapy

Abstract

Targeted temperature management (TTM) represents an effective therapy to improve neurologic outcome in patients who survive an out-of-hospital cardiac arrest (OHCA). First publications about this therapy reported a higher incidence of infections in patients who underwent TTM induced by external cooling devices. Whether intravascular cooling devices are also associated with an increased infection rate has not been investigated so far. In a single center retrospective study, the incidence of early onset pneumonia (EOP) in OHCA patients with or without intravascular TTM at 33°C target temperature for 24h who survived at least 24h after admission was analyzed. A total of 68OHCA survivors (mean age 65± 15years) were included in this analysis. The most common causes of OHCA were myocardial infarction (35 %), primary ventricular fibrillation (24 %), asystole (15 %), and pulmonary embolism (7 %). Of those, 32patients (48 %) received TTM. The overall incidence of EOP was 38 %. Incidence of EOP did not differ significantly between groups, was more frequent in the group without TTM (42 % vs. 34 %, p= 0.57) and had no impact on mortality (hazard ratio= 1.02; 95 % confidence interval 0.25-4.16; p= 0.97). Intravascular TTM at 33°C with a cooling catheter is not associated with more infective complications in OHCA patients. This finding underscores the safety of TTM.