Dataset Information

Outcomes of mild-to-moderate postresuscitation shock after non-shockable cardiac arrest and association with temperature management: a post hoc analysis of HYPERION trial data.

ABSTRACT:

Background

Outcomes of postresuscitation shock after cardiac arrest can be affected by targeted temperature management (TTM). A post hoc analysis of the "TTM1 trial" suggested higher mortality with hypothermia at 33 °C. We performed a post hoc analysis of HYPERION trial data to assess potential associations linking postresuscitation shock after non-shockable cardiac arrest to hypothermia at 33 °C on favourable functional outcome.

Methods

We divided the patients into groups with vs. without postresuscitation (defined as the need for vasoactive drugs) shock then assessed the proportion of patients with a favourable functional outcome (day-90 Cerebral Performance Category [CPC] 1 or 2) after hypothermia (33 °C) vs. controlled normothermia (37 °C) in each group. Patients with norepinephrine or epinephrine > 1 µg/kg/min were not included.

Results

Of the 581 patients included in 25 ICUs in France and who did not withdraw consent, 339 had a postresuscitation shock and 242 did not. In the postresuscitation-shock group, 159 received hypothermia, including 14 with a day-90 CPC of 1-2, and 180 normothermia, including 10 with a day-90 CPC of 1-2 (8.81% vs. 5.56%, respectively; P = 0.24). After adjustment, the proportion of patients with CPC 1-2 also did not differ significantly between the hypothermia and normothermia groups (adjusted hazards ratio, 1.99; 95% confidence interval, 0.72-5.50; P = 0.18). Day-90 mortality was comparable in these two groups (83% vs. 86%, respectively; P = 0.43).

Conclusions

After non-shockable cardiac arrest, mild-to-moderate postresuscitation shock at intensive-care-unit admission did not seem associated with day-90 functional outcome or survival. Therapeutic hypothermia at 33 °C was not associated with worse outcomes compared to controlled normothermia in patients with postresuscitation shock. Trial registration ClinicalTrials.gov, NCT01994772.

SUBMITTER: Ziriat I

PROVIDER: S-EPMC9576832 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Outcomes of mild-to-moderate postresuscitation shock after non-shockable cardiac arrest and association with temperature management: a post hoc analysis of HYPERION trial data.

Ziriat Ines I Le Thuaut Aurélie A Colin Gwenhael G Merdji Hamid H Grillet Guillaume G Girardie Patrick P Souweine Bertrand B Dequin Pierre-François PF Boulain Thierry T Frat Jean-Pierre JP Asfar Pierre P Francois Bruno B Landais Mickael M Plantefeve Gaëtan G Quenot Jean-Pierre JP Chakarian Jean-Charles JC Sirodot Michel M Legriel Stéphane S Massart Nicolas N Thevenin Didier D Desachy Arnaud A Delahaye Arnaud A Botoc Vlad V Vimeux Sylvie S Martino Frederic F Reignier Jean J Cariou Alain A Lascarrou Jean Baptiste JB

Annals of intensive care 20221017 1

<h4>Background</h4>Outcomes of postresuscitation shock after cardiac arrest can be affected by targeted temperature management (TTM). A post hoc analysis of the "TTM1 trial" suggested higher mortality with hypothermia at 33 °C. We performed a post hoc analysis of HYPERION trial data to assess potential associations linking postresuscitation shock after non-shockable cardiac arrest to hypothermia at 33 °C on favourable functional outcome.<h4>Methods</h4>We divided the patients into groups with vs ...[more]

PMID: 36251223

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Dataset Information

Outcomes of mild-to-moderate postresuscitation shock after non-shockable cardiac arrest and association with temperature management: a post hoc analysis of HYPERION trial data.

Background

Methods

Results

Conclusions

Publications

Outcomes of mild-to-moderate postresuscitation shock after non-shockable cardiac arrest and association with temperature management: a post hoc analysis of HYPERION trial data.

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