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.
| 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. |
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| Authors: | Ziriat I; Médecine Intensive Réanimation, University Hospital Centre, Nantes, France.; Le Thuaut A; Direction de la Recherche Clinique et l'Innovation, Plateforme de Méthodologie et Biostatistique, University Hospital Centre, Nantes, France.; Colin G; Medecine Intensive Reanimation, District Hospital Center, La Roche-sur-Yon, France.; AfterROSC Network, Paris, France.; Merdji H; Université de Strasbourg (UNISTRA), Faculté de Médecine; Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Service de Médecine Intensive Réanimation, Strasbourg, France.; INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France.; Grillet G; Medical Intensive Care Unit, South Brittany General Hospital Centre, Lorient, France.; Girardie P; Médecine Intensive Réanimation, CHU Lille, 59000, Lille, France.; Faculté de Médicine, Université de Lille, 59000, Lille, France.; Souweine B; Medical Intensive Care Unit, University Hospital Centre, Clermond-Ferrand, France.; Dequin PF; INSERM CIC1415, CHRU de Tours, Tours, France.; Medical Intensive Care Unit, University Hospital Centre, Tours, France.; Inserm UMR 1100 - Centre d'Étude des Pathologies Respiratoires, Tours University, Tours, France.; Boulain T; Medical Intensive Care Unit, Regional Hospital Centre, Orleans, France.; Frat JP; Médecine Intensive Réanimation, CHU de Poitiers, Poitiers, France.; INSERM, CIC-1402, ALIVES, Poitiers, France.; Université de Poitiers, Faculté de Médecine et de Pharmacie de Poitiers, Poitiers, France.; Asfar P; Medical Intensive Care Unit, University Hospital Centre, Angers, France.; Francois B; Service de Réanimation Polyvalente, University Hospital Centre, Limoges, France.; INSERM CIC 1435 & UMR 1092, University Hospital Centre, Limoges, France.; Landais M; Medical-Surgical Intensive Care Unit, Community Hospital Centre, Le Mans, France.; Plantefeve G; Medical-Surgical Intensive Care Unit, Community Hospital Centre, Argenteuil, France.; Quenot JP; Medical Intensive Care Unit, University Hospital Centre, Dijon, France.; Chakarian JC; Medical-Surgical Intensive Care Unit, Community Hospital Centre, Roanne, France.; Sirodot M; Medical-Surgical Intensive Care Unit, Community Hospital Centre, Annecy, France.; Legriel S; AfterROSC Network, Paris, France.; Medical-Surgical Intensive Care Unit, Versailles Hospital, Versailles, France.; Massart N; Medical-Surgical Intensive Care Unit, Community Hospital Centre, Saint Brieuc, France.; Thevenin D; Medical-Surgical Intensive Care Unit, Community Hospital Centre, Lens, France.; Desachy A; Medical-Surgical Intensive Care Unit, Community Hospital Centre, Angoulême, France.; Delahaye A; Medical-Surgical Intensive Care Unit, Community Hospital Centre, Rodez, France.; Botoc V; Medical-Surgical Intensive Care Unit, Community Hospital Centre, Saint Malo, France.; Vimeux S; Medical-Surgical Intensive Care Unit, Community Hospital Centre, Montauban, France.; Martino F; Medical Intensive Care Unit, University Hospital Centre, Pointe-à-Pitre, France.; Reignier J; Médecine Intensive Réanimation, University Hospital Centre, Nantes, France.; Cariou A; AfterROSC Network, Paris, France.; Medical Intensive Care Unit, Cochin Hospital (APHP) and University of Paris, Paris, France.; Paris Cardiovascular Research Centre, INSERM U970, Paris, France.; Lascarrou JB; Médecine Intensive Réanimation, University Hospital Centre, Nantes, France. Jeanbaptiste.lascarrou@chu-nantes.fr.; AfterROSC Network, Paris, France. Jeanbaptiste.lascarrou@chu-nantes.fr.; Paris Cardiovascular Research Centre, INSERM U970, Paris, France. Jeanbaptiste.lascarrou@chu-nantes.fr.; Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire, 30 Boulevard Jean Monnet, 44093, Nantes Cedex 1, France. Jeanbaptiste.lascarrou@chu-nantes.fr. |
| Source: | Annals of intensive care [Ann Intensive Care] 2022 Oct 17; Vol. 12 (1), pp. 96. Date of Electronic Publication: 2022 Oct 17. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 101562873 Publication Model: Electronic Cited Medium: Print ISSN: 2110-5820 (Print) Linking ISSN: 21105820 NLM ISO Abbreviation: Ann Intensive Care Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Heidelberg : Springer-Verlag, 2011- |
| 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.; (© 2022. The Author(s).) |
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| Grant Information: | PHRCI1369057N French Ministry of Health |
| Contributed Indexing: | Keywords: Cardiac arrest; In-hospital; Postresuscitation shock; Targeted temperature management; Therapeutic hypothermia |
| Molecular Sequence: | ClinicalTrials.gov NCT01994772 |
| Entry Date(s): | Date Created: 20221017 Latest Revision: 20260329 |
| Update Code: | 20260329 |
| PubMed Central ID: | PMC9576832 |
| DOI: | 10.1186/s13613-022-01071-z |
| PMID: | 36251223 |
| Database: | MEDLINE |
Journal Article