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Association of time-temperature curves with outcomes in temperature management for cardiac arrest.

dc.contributor.author Luedke, Matthew William
dc.contributor.author Graffagnino, Carmelo
dc.contributor.author McKinney, B Grace
dc.contributor.author Piper, Jill
dc.contributor.author Iversen, Edwin
dc.contributor.author Kolls, Brad
dc.date.accessioned 2022-06-03T12:42:40Z
dc.date.available 2022-06-03T12:42:40Z
dc.date.issued 2022-01
dc.identifier bmjno-2022-000273
dc.identifier.issn 2632-6140
dc.identifier.issn 2632-6140
dc.identifier.uri https://hdl.handle.net/10161/25095
dc.description.abstract <h4>Background/purpose</h4>Cardiac arrest is a common cause of death and neurological injury; therapeutic cooling for neuroprotection is standard of care. Despite numerous and ongoing trials targeting a specified cooling temperature for a target duration, the concept of temperature dose-the duration spent at a given depth of hypothermia-is not as well explored.<h4>Methods</h4>In this retrospective study, we examined 66 patients 18 years of age or older undergoing therapeutic hypothermia for cardiac arrest between 2007 and 2010 to assess the relationship of temperature dose with outcomes. Demographic, clinical, outcome and temperature data were collected. Demographic and clinical data underwent bivariate regression analysis for association with outcome. Time-temperature curves were divided into pre-determined temperature thresholds and assessed by logistic regression analysis for association with outcome. A second, multivariate regression analysis was performed controlling for factors associated with poor outcomes.<h4>Results</h4>Old age was significantly associated with poor outcome and a shockable arrest rhythm was significantly associated with positive outcome. Subjects spent an average of 2.82 hours below 35°C, 7.31 hours ≥35°C to ≤36.5°C, 24.75 hours >36.5 to <38.0°C and 7.06 hours ≥38°C. Logistic regression analysis revealed borderline significant positive association between good outcome and time at a cooling depth (35°C-36.5°C, p=0.05); adjusted for old age, the association became significant (p=0.04).<h4>Conclusion</h4>Controlling for old age, longer durations between >35°C, ≤36.5°C during therapeutic hypothermia for cardiac arrest were significantly associated with good clinical outcomes. Time spent within a given temperature range may be useful for measuring the effect of temperature management.
dc.language eng
dc.publisher BMJ
dc.relation.ispartof BMJ neurology open
dc.relation.isversionof 10.1136/bmjno-2022-000273
dc.subject CLINICAL NEUROLOGY
dc.subject INTENSIVE CARE
dc.title Association of time-temperature curves with outcomes in temperature management for cardiac arrest.
dc.type Journal article
duke.contributor.id Luedke, Matthew William|0563708
duke.contributor.id Graffagnino, Carmelo|0109406
duke.contributor.id Iversen, Edwin|0136275
duke.contributor.id Kolls, Brad|0278390
dc.date.updated 2022-06-03T12:42:39Z
pubs.begin-page e000273
pubs.issue 1
pubs.organisational-group Duke
pubs.organisational-group School of Medicine
pubs.organisational-group Trinity College of Arts & Sciences
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Institutes and Centers
pubs.organisational-group Statistical Science
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Provost's Academic Units
pubs.organisational-group Neurology
pubs.organisational-group Neurology, Neurocritical Care
pubs.organisational-group Initiatives
pubs.organisational-group Duke Science & Society
pubs.organisational-group Hospital Neurology
pubs.publication-status Published
pubs.volume 4
duke.contributor.orcid Luedke, Matthew William|0000-0002-1564-0241


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