Severe or critical hypotension during post cardiac arrest care is associated with factors available on admission - a post hoc analysis of the TTH48 trial

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Hästbacka , J , Kirkegaard , H , Soreide , E , Taccone , F S , Rasmussen , B S , Storm , C , Kjaergaard , J , Laitio , T , Duez , C H V , Jeppesen , A N , Grejs , A M & Skrifvars , M B 2021 , ' Severe or critical hypotension during post cardiac arrest care is associated with factors available on admission - a post hoc analysis of the TTH48 trial ' , Journal of Critical Care , vol. 61 , pp. 186-190 . https://doi.org/10.1016/j.jcrc.2020.10.026

Title: Severe or critical hypotension during post cardiac arrest care is associated with factors available on admission - a post hoc analysis of the TTH48 trial
Author: Hästbacka, Johanna; Kirkegaard, Hans; Soreide, Eldar; Taccone, Fabio Silvio; Rasmussen, Bodil Steen; Storm, Christian; Kjaergaard, Jesper; Laitio, Timo; Duez, Christophe Henri Valdemar; Jeppesen, Anni N.; Grejs, Anders M.; Skrifvars, Markus B.
Contributor organization: Clinicum
HUS Perioperative, Intensive Care and Pain Medicine
Department of Diagnostics and Therapeutics
Anestesiologian yksikkö
HUS Emergency Medicine and Services
Date: 2021-02
Language: eng
Number of pages: 5
Belongs to series: Journal of Critical Care
ISSN: 0883-9441
DOI: https://doi.org/10.1016/j.jcrc.2020.10.026
URI: http://hdl.handle.net/10138/339934
Abstract: Purpose: We explored whether severe or critical hypotension can be predicted, based on patient and resuscitation characteristics in out-of-hospital cardiac arrest (OHCA) patients. We also explored the association of hypotension with mortality and neurological outcome. Materials and methods: We conducted a post hoc analysis of the TTH48 study (NCT01689077), where 355 out-of-hospital cardiac arrest (OHCA) patients were randomized to targeted temperature management (TTM) treatment at 33 degrees C for either 24 or 48 h. We recorded hypotension, according to four severity categories, within four days from admission. We used multivariable logistic regression analysis to test association of admission data with severe or critical hypotension. Results: Diabetes mellitus (OR 3.715, 95% CI 1.180-11.692), longer ROSC delay (OR 1.064, 95% CI 1.022-1.108), admission MAP (OR 0.960, 95% CI 0.929-0.991) and non-shockable rhythm (OR 5.307, 95% CI 1.604-17.557) were associated with severe or critical hypotension. Severe or critical hypotension was associated with increased mortality and poor neurological outcome at 6 months. Conclusions: Diabetes, non-shockable rhythm, longer delay to ROSC and lower admission MAP were predictors of severe or critical hypotension. Severe or critical hypotension was associated with poor outcome. (C) 2020 Published by Elsevier Inc.
Subject: Out-of-hospital cardiac arrest
Hemodynamics
Hypotension
Targeted temperature management
Predicting
Outcome
TARGETED TEMPERATURE MANAGEMENT
MILD THERAPEUTIC HYPOTHERMIA
MEAN ARTERIAL-PRESSURE
VASOPRESSOR SUPPORT
SHOCK
36-DEGREES-C
HEMODYNAMICS
33-DEGREES-C
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: acceptedVersion


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