Published in:
01-02-2017 | Original Article
Targeted temperature management in cardiovascular disease complicated by cardiac arrest
Published in: Irish Journal of Medical Science (1971 -) | Issue 1/2017
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Purpose
The majority of cardiac arrests occur due to cardiovascular etiology. Targeted temperature management (TTM) (32–34 °C) is a part of the standard post arrest care. We hypothesized that lower body temperature may lead to reduced cardiac metabolic demand and potentially have a beneficial effect on myocardial function.
Methods
We performed a retrospective study on patients admitted to the intensive care unit following cardiac arrest secondary to cardiovascular etiology over a 9 year period. We assessed the impact of TTM on neurological and cardiac outcomes.
Results
There were 57 patients in the cohort; 21 patients in the TTM group and 36 in the non-TTM group. Demographic characteristics were similar in both groups—the majority of patients (86 vs 80 %, respectively) were males in their 60s. Neurological outcomes were similar; 24 % of patients died during the ICU admission in the TTM group vs 18 % in the non-TTM group. Mean GCS on admission to the ICU was 4 vs 7, respectively, and 11 at discharge in both groups. Majority of patients recovered good neurological function (GCS ≥ 13)—57 % in the TTM group vs 64 % in the non-TTM group. The change in left ventricular function over a 6 month follow up period was significantly better in patients who received targeted temperature management—mean change of +4.4 vs −3.3 %, respectively. This proved to be statistically significant (p = 0.02).
Conclusions
The study demonstrates a possible beneficial effect of TTM on long-term cardiac function, when instituted following cardiac arrest.