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Open Access 01-12-2022 | Shock | Research

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

Authors: Ines Ziriat, Aurélie Le Thuaut, Gwenhael Colin, Hamid Merdji, Guillaume Grillet, Patrick Girardie, Bertrand Souweine, Pierre-François Dequin, Thierry Boulain, Jean-Pierre Frat, Pierre Asfar, Bruno Francois, Mickael Landais, Gaëtan Plantefeve, Jean-Pierre Quenot, Jean-Charles Chakarian, Michel Sirodot, Stéphane Legriel, Nicolas Massart, Didier Thevenin, Arnaud Desachy, Arnaud Delahaye, Vlad Botoc, Sylvie Vimeux, Frederic Martino, Jean Reignier, Alain Cariou, Jean Baptiste Lascarrou

Published in: Annals of Intensive Care | Issue 1/2022

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

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Title: 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
Authors: Ines Ziriat
Aurélie Le Thuaut
Gwenhael Colin
Hamid Merdji
Guillaume Grillet
Patrick Girardie
Bertrand Souweine
Pierre-François Dequin
Thierry Boulain
Jean-Pierre Frat
Pierre Asfar
Bruno Francois
Mickael Landais
Gaëtan Plantefeve
Jean-Pierre Quenot
Jean-Charles Chakarian
Michel Sirodot
Stéphane Legriel
Nicolas Massart
Didier Thevenin
Arnaud Desachy
Arnaud Delahaye
Vlad Botoc
Sylvie Vimeux
Frederic Martino
Jean Reignier
Alain Cariou
Jean Baptiste Lascarrou
Publication date: 01-12-2022
Publisher: Springer International Publishing
Keywords: Shock
Shock
Temperature Management
Published in: Annals of Intensive Care / Issue 1/2022
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/s13613-022-01071-z

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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

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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