Target temperature in post-arrest comatous patients. Is something changed in the postpandemic era?

Abstract

Introduction: The recommended target temperature in the treatment of comatous patients after cardiac arrest has recently changed. We analyzed the impact on the neurological outcome of a change in the target temperature from July 2021.

Material and methods: This was a retrospective analysis comparing the discharge status of 78 patients with a target temperature of 33 °C (group 1) with that of 24 patients with a target temperature of 36.5 °C (group 2). Pearson chi-square and Mann-Whitney U tests were used.

Results: The initial rhythm was defibrillable in 65% of group 1 and 71% of group 2, and cardiac arrest was witnessed in 93% of group 1 and 96% of group 2. There was an adverse outcome (death or vegetative state) in 37 patients in group 1 (47%) compared to 18 in group 2 (74%) (Pearson chi-square 5.612, p = 0.018).

Conclusions: In our series of patients, the temperature control target temperature change from 33 °C to 36.5 °C was associated with worse neurological outcome. Further studies are needed to evaluate the outcome of a generalized modification of temperature control targets in comatose patients after cardiac arrest in our postpandemic era.

Keywords: Cardiac arrest; Comatose; Therapeutic hypothermia.