Abstract
IntroductionPatients after out-of-hospital cardiac arrest (OHCA) benefit from therapeutic hypothermia for 24 hours. The time needed to reach hypothermia (target temperature of 32°C to 34°C) varies widely. In this study, we explore the relation between measures of body composition and the time needed to reach target temperature with hypothermia.MethodWe conducted a prospective observational study in patients treated with hypothermia after OHCA. Data collected included weight and height, body composition by anthropometric measures and by single-frequency body impedance, and waist-to-hip ratio. Analysis of concordance between impedance and anthropometric measures and hazard ratios of achieving target temperature (event) corrected for different body composition measures.ResultsTwenty-seven patients were included. The median (interquartile range) time to reach target temperature after admission to the intensive care unit was 191 (105 to 382) minutes. Intraclass correlation for total body fat (TBF) measures was 0.94 (95% confidence interval [CI] 0.89 to 0.97). Only TBF percentage (anthropometrics by the Durnin's table) appeared to be associated with time to reach target temperature: 0.93 (95% CI 0.87 to 0.99; P = 0.03).ConclusionThe body composition measures from single-frequency impedance and anthropometrics appear to be very concordant. Only TBF percentage (anthropometrics) showed a significant but clinically irrelevant influence on time needed to achieve target temperature with hypothermia. We conclude that there are no indications to adjust current cooling practice toward the body composition of patients.
Highlights
Patients after out-of-hospital cardiac arrest (OHCA) benefit from therapeutic hypothermia for 24 hours
total body fat (TBF) percentage appeared to be associated with time to reach target temperature: 0.93
In the present study, we determined the relation between body composition and the temperature course during therapeutic hypothermia
Summary
Patients after out-of-hospital cardiac arrest (OHCA) benefit from therapeutic hypothermia for 24 hours. The time needed to reach hypothermia (target temperature of 32°C to 34°C) varies widely. We explore the relation between measures of body composition and the time needed to reach target temperature with hypothermia. Times needed to achieve target temperature with hypothermia (32°C to 34°C) vary widely, from 0.5 to 8 hours or even longer [6]. We hypothesized that the variation of the time needed to achieve the target temperature was caused, at least in part, by patient factors such as weight and fat percentage. In the present study, we determined the relation between body composition and the temperature course during therapeutic hypothermia. Both anthropometric and bioelectrical impedance measures were used to estimate body composition
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