Impact of sedation depth on neurological outcome in post-cardiac arrest patients - A retrospective cohort study.

IF 6.5 1区医学 Q1 CRITICAL CARE MEDICINE

Resuscitation Pub Date : 2024-12-01 Epub Date: 2024-12-02 DOI:10.1016/j.resuscitation.2024.110456

Dawid Leander Staudacher, Laura Heine, Jonathan Rilinger, Alexander Maier, Felix A Rottmann, Viviane Zotzmann, Klaus Kaier, Paul Marc Biever, Alexander Supady, Dirk Westermann, Tobias Wengenmayer, Markus Jäckel

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引用次数: 0

Abstract

Aims: Whether targeted temperature management (TTM) might improve neurologic prognosis in patients after cardiac arrest is currently under debate. Data concerning sedation depth during TTM is rare. This study aimed to compare the impact of different sedation depths on neurological outcomes in post-cardiac arrest patients undergoing TTM.

Methods: In this retrospective, before-and-after registry study, all patients receiving TTM on a medical ICU between 08/2016 and 03/2021 were included. This study evaluated the following sedation targets: RASS-target during TTM -5 until 08/2019 and RASS-target -4 since 09/2019. The primary endpoint was favorable neurological outcome at ICU discharge, defined as a Cerebral Performance Category (CPC) score of 1 or 2.

Results: 403 patients were included (RASS-target -5: N = 285; RASS-target -4: N = 118). Favorable neurological outcome was documented in 54/118 (45.8 %) patients in the group with a RASS-target of -4 compared to 111/285 (38.9 %) in the group with a RASS-target of -5. After adjustment for age, sex, initial shockable rhythm, bystander CPR, duration of CPR and mean arterial pressure 12 h after CPR, favorable neurological outcome was associated with RASS-target -4 (OR 1.82 (95 % CI: 1.02-3.23); p = 0.042). ICU survival was similar in both groups while 30-day survival was associated with RASS-target -4 (OR 1.81 (1.01-3.26); p = 0.047).

Conclusion: Lighter sedation strategies during TTM after cardiac arrest might improve outcome and should be further investigated.

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来源期刊

Resuscitation 医学-急救医学

CiteScore

12.00

自引率

18.50%

发文量

556

审稿时长

21 days

期刊介绍： Resuscitation is a monthly international and interdisciplinary medical journal. The papers published deal with the aetiology, pathophysiology and prevention of cardiac arrest, resuscitation training, clinical resuscitation, and experimental resuscitation research, although papers relating to animal studies will be published only if they are of exceptional interest and related directly to clinical cardiopulmonary resuscitation. Papers relating to trauma are published occasionally but the majority of these concern traumatic cardiac arrest.