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Article Abstract

This study aimed to investigate whether targeted temperature management (TTM) could enhance outcomes in patients with out-of-hospital cardiac arrest (OHCA) treated with extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest. Using a nationwide OHCA registry, adult patients with witnessed OHCA of presumed cardiac origin who underwent ECPR at the emergency department between 2008 and 2021 were included. We examined the effect of ECPR with TTM on survival and neurological outcomes at hospital discharge using propensity score matching and multivariable logistic regression compared with patients treated with ECPR without TTM. Odds ratios and 95% confidence intervals were determined. A total of 399 ECPR cases were analyzed among 380,239 patients with OHCA. Of these, 330 underwent ECPR without TTM and 69 with TTM. After propensity score matching, 69 matched pairs of patients were included in the analysis. No significant differences in survival and good neurological outcomes between the two groups were observed. In the multivariable logistic regression, no significant differences were observed in survival and neurological outcomes between ECPR with and without TTM. Among the patients who underwent ECPR after OHCA, ECPR with TTM did not improve outcomes compared with ECPR without TTM.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10890305PMC
http://dx.doi.org/10.3390/jpm14020185DOI Listing

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Aim: Targeted temperature management (TTM) for patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) has not been fully studied. This study aimed to investigate the association between blood glucose levels during TTM and neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients undergoing ECPR.

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Article Synopsis
  • - ECPR can enhance survival and neurological recovery for patients suffering from out-of-hospital cardiac arrest (OHCA), but elevated levels of arterial oxygen can hinder these outcomes, particularly in the context of targeted temperature management (TTM).
  • - This study analyzed data from a larger registry of ECPR cases, focusing on the impact of prolonged hyperoxemia, defined as a partial pressure of arterial oxygen (PaO) of 300 mmHg or higher, during the initial days of intensive care.
  • - Findings indicate that prolonged hyperoxemia negatively affects both survival and neurological recovery post-ECPR, with factors such as age and initial heart rhythm also playing critical roles in patient outcomes.
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Article Synopsis
  • This study investigates the link between rewarming durations and neurological outcomes in patients who underwent extracorporeal cardiopulmonary resuscitation (ECPR) with targeted temperature management (TTM) after experiencing out-of-hospital cardiac arrest (OHCA).
  • The research is a secondary analysis of data from the Advanced Life Support Study Registry in Japan, focusing on patients with either a TTM of 34°C or below.
  • Findings show that a shorter rewarming duration (<24 hours) was not significantly associated with better neurological outcomes or survival rates compared to longer durations (24 hours or >24 hours).
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