FACTORS ASSOCIATED WITH FAVORABLE OUTCOMES IN CARDIAC ARREST AND TARGET TEMPERATURE MANAGEMENT

Abstract

SESSION TITLE: Late Breaking Posters in Critical CareSESSION TYPE: Original Investigation PostersPRESENTED ON: 10/18/2022 01:30 pm - 02:30 pmPURPOSE: While guidelines strongly recommend targeted temperature management (TTM), whether early initiation of TTM or time-to-target temperature (TTT) are associated with better outcomes remains elucidated.METHODS: This is a retrospective observational study at a tertiary care hospital in Honolulu, Hawaii. Those who had an out-of-hospital or in-hospital cardiac arrest (OHCA or IHCA) undergoing TTM from November 1, 2020 to August 31, 2021 were included. Patients were dichotomized by the median time to TTM initiation, time from initiation of TTM to achieve target temperature, and TTT (into early and delayed groups).RESULTS: 86 patients (53 with OHCA and 33 with IHCA), mainly including Asian and Native Hawaiian and Pacific Islanders, were included. In multinominal logistic regression analysis, both Δ-temperature and TTT were not identified as factors associated with favorable neurological outcomes in neither OHCA nor IHCA groups. In the IHCA group, however, Δ-temperature and TTT were identified as factors associated with mortality, with a higher chance of survival in higher Δ-temperature (p = 0.039) and higher mortality in longer TTT patients (p = 0.017).CONCLUSIONS: There may be specific groups of patients who are likely to benefit from the prompt initiation of TTM, focusing on Δ-temperature as a variable of interest. Further studies are warranted to identify underlying mechanisms associated with the results and response to TTM in different races/ethnicities.CLINICAL IMPLICATIONS: The present study showed that there might be specific groups of patients who are likely to benefit from the prompt introduction of TTM, focusing on patients with baseline hyperthermia such as sepsis. Also, the results suggest the need to investigate the difference in response to TTM based on race and ethnicity since existing large-scale studies mainly included Caucasian patients.DISCLOSURES:No relevant relationships by Hangyul Chung-EsakiNo relevant relationships by Nobuhiko KimuraNo relevant relationships by Yoshito Nishimura SESSION TITLE: Late Breaking Posters in Critical Care SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: While guidelines strongly recommend targeted temperature management (TTM), whether early initiation of TTM or time-to-target temperature (TTT) are associated with better outcomes remains elucidated. METHODS: This is a retrospective observational study at a tertiary care hospital in Honolulu, Hawaii. Those who had an out-of-hospital or in-hospital cardiac arrest (OHCA or IHCA) undergoing TTM from November 1, 2020 to August 31, 2021 were included. Patients were dichotomized by the median time to TTM initiation, time from initiation of TTM to achieve target temperature, and TTT (into early and delayed groups). RESULTS: 86 patients (53 with OHCA and 33 with IHCA), mainly including Asian and Native Hawaiian and Pacific Islanders, were included. In multinominal logistic regression analysis, both Δ-temperature and TTT were not identified as factors associated with favorable neurological outcomes in neither OHCA nor IHCA groups. In the IHCA group, however, Δ-temperature and TTT were identified as factors associated with mortality, with a higher chance of survival in higher Δ-temperature (p = 0.039) and higher mortality in longer TTT patients (p = 0.017). CONCLUSIONS: There may be specific groups of patients who are likely to benefit from the prompt initiation of TTM, focusing on Δ-temperature as a variable of interest. Further studies are warranted to identify underlying mechanisms associated with the results and response to TTM in different races/ethnicities. CLINICAL IMPLICATIONS: The present study showed that there might be specific groups of patients who are likely to benefit from the prompt introduction of TTM, focusing on patients with baseline hyperthermia such as sepsis. Also, the results suggest the need to investigate the difference in response to TTM based on race and ethnicity since existing large-scale studies mainly included Caucasian patients. DISCLOSURES: No relevant relationships by Hangyul Chung-Esaki No relevant relationships by Nobuhiko Kimura No relevant relationships by Yoshito Nishimura