The association between early use of targeted temperature management and neurological outcome after cardiac arrest: a national registry research

Abstract

Abstract Introduction Targeted temperature management (TTM) was shown to have favorable outcome in patients with cardiac arrest. However, there were still limited publications about the impact of the time intervalsfromreturn of spontaneous circulation (ROSC) to the initiation of TTMin patients after cardiac arrest.The aim of this study is toinvestigate the association between the time intervalsfrom ROSC to the initiation of TTMand the favorable neurological outcomes. Methods The data used the Taiwan Network of Targeted Temperature Management for Cardiac arrest (TIMECARD) registry database. Patients with cardiac arrest received TTMwere collected from June 2018 to June 2019. Very early, early, late, very late, and delayed TTM groups were defined as the time from cardiac arrest to initiation of TTM 0 to 5 hours,5 to 8 hours, 8 to 11 hours, 11 to 14 hours, and >14 hours respectively. A totalof 559 patients were divided into5 groups: very early group (N=82), early (N=150), late (N=118), very late (N=71) and delayed group (N=138). Results The baseline character were not different among 5 groups. Favorable neurological outcomes (cerebral performance category 1 and 2) in the very early, early, late, very late and delayed groupswere 66.67%, 33.33%, 50%, 25%, and 14.29% respectively. The Cox analysis showed very late and delayed group had worse neurologic outcome (HR=1.829, 95% CI=1.04- 3.23, p=0.0371). There is also trend to have worse neurologic outcome in late group (HR=1.734, 95% CI=0.91- 3.30, p=0.0939). Conclusion This national registry study demonstrated that early initiation of TTM in patients with cardiac arrest was associated with improved favorable neurological outcomes compared with those with late initiation of TTM. Funding Acknowledgement Type of funding source: None