Therapeutic hypothermia and temperature management最新文献

{"title":"Acute Kidney Injury after Hypoxic Ischemic Encephalopathy in Neonates Treated with Passive Versus Active Total Body Cooling.","authors":"Ahmed K Bamaga, Heidi K Alwassia, Abdulaziz A Al-Khotani, Yaser Al-Bal'awi, Sumayyah Kobeisy, Mohammed A Alsubaie, Anas S Alyazidi","doi":"10.1089/ther.2024.0046","DOIUrl":"10.1089/ther.2024.0046","url":null,"abstract":"<p><p>Hypoxic-ischemic encephalopathy (HIE) affects 1-2 per 1000 term live births, often resulting in severe long-term disabilities. Therapeutic hypothermia (TH) is the standard care in developed countries, but high costs of modern cooling devices necessitate low-cost alternatives. This study compares passive cooling with active machine cooling regarding short-term renal outcomes, specifically acute kidney injury (AKI), in neonates with HIE. This retrospective study was conducted at Dr. Soliman Fakeeh Hospital's neonatal intensive care unit from 2019 to 2023. The study analyzed patient demographics, clinical outcomes, and laboratory data (sodium, potassium, urea, and creatinine) to assess AKI. Treatment involved whole-body cooling at 33.5-34.5°C for 72 hours, followed by gradual rewarming. A total of 39 neonates were included in the study. Both cooling methods showed similar short-term renal outcomes, with no statistically significant differences in creatinine levels between the groups at baseline, 24 hours, 72 hours, or discharge. A trend of higher creatinine levels in the passive cooling group was observed, but it did not reach statistical significance. The median length of hospital stay was longer in the passive cooling group, though this difference was marginally nonsignificant. Long-term follow-up revealed no significant differences in chronic kidney disease incidence or neurodevelopmental outcomes between the groups. This study found no significant differences in both short-term renal outcomes and long-term effects between passive and active cooling methods in neonates with HIE. However, the trend of higher creatinine levels in the passive cooling group suggests the need for further investigation with larger sample sizes and extended follow-up to clarify the long-term effects of cooling methods on renal and neurodevelopmental outcomes in neonates with HIE.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"147-152"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Temperature Chain Management Scheme During Gynecological Laparoscopic Surgery Under General Anesthesia.","authors":"Lanxia Pan, Yuelei Dong, Fengxia Chen","doi":"10.1177/21537658251372312","DOIUrl":"https://doi.org/10.1177/21537658251372312","url":null,"abstract":"<p><p>This study aimed to explore the effect of the temperature chain management scheme on inadvertent perioperative hypothermia (IPH) during gynecological laparoscopic surgery. A total of 48 female adult patients who underwent elective gynecological laparoscopic surgery under general anesthesia from November 2023 to April 2024 in a teaching hospital were enrolled and randomized to receive either intraoperative prewarming fluid alone (Group C) or temperature chain management (Group T). Comparing the perioperative core and peripheral temperatures, IPH rates, shivering in postanesthesia care unit (PACU), and thermal comfort in two groups, perioperative core temperature of Group T was higher than that of Group C (<i>p</i> < 0.05); IPH rates and the incidence of shivering in PACU of Group T were lower than that of Group C (<i>p</i> < 0.05); Group T scored higher in thermal comfort than Group C when entering PACU (<i>p</i> < 0.05). This study reports that the use of intraoperative prewarming fluid alone does not sufficiently warm the patients. The optimal temperature management is achieved when using temperature chain management during gynecological laparoscopic surgery.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Prognostic Model for Predicting Adverse Outcomes in Neonates with Hypoxic-Ischemic Encephalopathy before Therapeutic Hypothermia.","authors":"Tomonori Kurimoto, Takuya Tokuhisa, Itaru Hayasaka, Hiroshi Ohashi, Tsuyoshi Yamamoto, Eiji Hirakawa, Takatsugu Maeda, Masato Kamitomo, Satoshi Ibara","doi":"10.1177/21537658251370513","DOIUrl":"https://doi.org/10.1177/21537658251370513","url":null,"abstract":"<p><p>Hypoxic-ischemic encephalopathy (HIE) affects 1.3-1.7 per 1000 live births and remains a major cause of neurodevelopmental impairment (NDI). Despite therapeutic hypothermia (TH), nearly half of infants with moderate to severe HIE experience death or NDI. Identifying early prognostic indicators before TH initiation is crucial for improving management and outcomes. We conducted a retrospective case-control study of 144 infants with HIE treated with TH at Kagoshima City Hospital (2000-2022); 100 underwent developmental evaluations at 18 months. Clinical parameters, including amplitude-integrated EEG (aEEG), Thompson scores, and resuscitation details, were analyzed. Logistic regression identified predictors of adverse outcomes: death, cerebral palsy, or developmental quotient <70. Univariate analysis revealed significant predictors, including low Apgar scores, low umbilical artery pH, aEEG abnormalities, high Thompson scores, and resuscitation details. Multivariate regression identified three independent predictors: aEEG abnormalities (adjusted odds ratios [aOR] 7.1, 95% confidence interval [CI]: 1.3-38.2), Thompson score ≥12 (aOR 5.4, 95% CI: 1.5-18.7), and chest compressions (aOR 31.6, 95% CI: 4.3-231.6). We developed and derived early prognostic model from these predictors, assigning +2 points for aEEG abnormalities, +2 points for a Thompson score ≥12, and +3 points for chest compressions. A total score ≥4 achieved high sensitivity (70.4%) and specificity (90.4%), with an area under the curve of 0.87 (95% CI: 0.77-0.94). The early prognostic model may serve as an effective tool for early risk stratification in neonates with HIE before TH initiation, supporting individualized treatment decisions. This score could help identify high-risk neonates who may benefit from additional neuroprotective strategies.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent Pulmonary Hypertension Among Infants Undergoing Therapeutic Hypothermia for Hypoxic Ischemic Encephalopathy: A Systematic Review and Meta-Analysis.","authors":"Rashida Javed, Tim J Van Hasselt, Narasimha Rao, Harsha Gowda","doi":"10.1177/21537658251370950","DOIUrl":"https://doi.org/10.1177/21537658251370950","url":null,"abstract":"<p><p>To perform a systematic review and meta-analysis to examine the association between persistent pulmonary hypertension (PPHN) and receipt of therapeutic hypothermia (TH), compared to those who did not receive TH, among infants with moderate or severe hypoxic-ischemic encephalopathy (HIE). Systematic review and meta-analysis based on Ovid, Medline, Embase and Cochrane central searches from 01/01/2000 to 31/03/2025. We included only randomized control trials for meta-analysis and followed international guidelines for conducting systematic reviews. The primary outcome of the study was PPHN in infants undergoing TH for moderate to severe HIE. Among 185 articles identified using search strategy, 19 articles were assessed for eligibility. Eight randomized control trials (RCTs) met the inclusion criteria, and seven were included in meta-analysis. A random effects model used for the outcome of PPHN, comparing TH with NT or usual care, involving a pooled population of 1006 infants across seven studies. The relative risk of PPHN for TH versus NT was 1.13 (95% confidence interval 0.81 to 1.57). We noted risk of bias in the blinding of participants across included RCTs. We assessed nine observational studies and performed a narrative review. We noted that a considerable number of infants developed PPHN across TH and NT groups. We did not find evidence of an association between TH and PPHN in infants with moderate to severe HIE, although a considerable number of infants developed PPHN across both groups. We suggest that clinicians should be aware of the risk of PPHN to allow prompt investigation and management.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Hemodynamics of Hypoxic Neonates During Therapeutic Hypothermia and the Warming Phase: A Literature Review.","authors":"Natalia Brunets, Veronika Brunets, Renata Bokiniec","doi":"10.1089/ther.2025.0035","DOIUrl":"https://doi.org/10.1089/ther.2025.0035","url":null,"abstract":"<p><p>This study aimed to evaluate the effects of therapeutic hypothermia (TH) and the warming phase on cardiovascular hemodynamics among neonates suffering from perinatal asphyxia. The reviewed literature on hemodynamic changes among neonates undergoing TH was obtained from the following databases: PubMed, Embase, POPLINE, Cochrane Reference Libraries, Google Scholar, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews. Search strategies included keywords, combinations, medical subject headings, and snowball searches of related articles. The following search terms were used: brain injury, hypoxic-ischemic encephalopathy, left ventricular (LV) dysfunction, right ventricular (RV) dysfunction, and TH. We selected publications evaluating RV and LV heart function and cerebral, renal, and visceral circulation function for analysis. There were 12 prospective studies, with a total of 361 patients in the study groups and 149 patients in the control groups. There were seven retrospective studies, with a total of 1637 patients. One study was a randomized controlled trial, one was a systematic review, and one was a Cochrane review. The limitations of the review are that most of the studies are observational, making it difficult to precisely assess the causes of the observed changes, whether they are related to asphyxia, hypothermia, or other pathology. The results of the observational studies were not consistent with those of the randomized trials for ethical reasons. The hemodynamic characteristics of the cardiovascular system during TH and the rewarming phase are significantly complex. Therefore, an in-depth understanding of the pathophysiological attributes associated with these aspects is essential to provide individualized therapeutic approaches for optimizing cerebral perfusion pressure and reducing secondary injuries.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144544969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment and Identification of a Deep Second-Degree Frostbite Model in Mouse Skin.","authors":"Tianwei Li, Dongwen Gao, Wenwen Wang, Xiao Li, Mingfei Han, Jie Ma, Yunping Zhu","doi":"10.1089/ther.2025.0003","DOIUrl":"https://doi.org/10.1089/ther.2025.0003","url":null,"abstract":"<p><p>The aim of this study is to address the limited research on skin frostbite models and the gaps in pathological identification of time-series injuries in frostbitten skin, which hinder comprehensive assessment of injury severity. A deep second-degree frostbite model was developed in BALB/c nude mice, and staining identification was performed at various stages, from the onset of frostbite to the healing process. Continuous observations at multiple time points provided a more accurate and comprehensive standard for comparison in frostbite treatment experiments. A deep second-degree frostbite model was developed using BALB/c nude mice. Histopathological examination was performed with hematoxylin-eosin (HE) staining, while Masson's Trichrome (MT) staining was used to observe collagen recovery. Additionally, immunofluorescence staining was conducted to analyze epidermal cells and dermal structures. A deep second-degree frostbite model was successfully developed in BALB/c nude mice. Histopathological characteristics of mouse skin tissue were examined through HE staining at various time points. MT staining highlighted changes in the morphology and thickness of the original fibers. Immunofluorescence staining offered a detailed evaluation of the damage and recovery of appendages, including hair follicles and sweat glands. The deep second-degree frostbite model in BALB/c nude mice establishes a standard for studying skin frostbite injuries and developing related treatments.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Predictive Nomogram for Intraoperative Hypothermia in Elderly Patients Undergoing Da Vinci Robot-Assisted Urological Tumor Resection: A Retrospective Cohort Study.","authors":"Xiaoyan Song, Siyu Jin, Minghui Ma, Haiwen Zheng, Liang Xin, Liu Tiantian","doi":"10.1089/ther.2024.0050","DOIUrl":"https://doi.org/10.1089/ther.2024.0050","url":null,"abstract":"<p><p>This study aims to construct a Nomogram for intraoperative hypothermia (IH) in elderly patients undergoing robot-assisted urological tumor resection (RAUTR) and to evaluate the effect of the model by internal and external validation. Using convenient sampling to enroll patients in a large hospital from February 2022 to July 2024 as the modeling and validation cohort. Identifying the independent risk factors for IH by univariate and multivariate logistic regression, and developing a Nomogram by the R software. The Nomogram's discrimination and accuracy were tested by receiver operating characteristic (ROC) curves and the Hosmer-Lemeshow (H-L) test, internal validation was performed with 1000 Bootstrap resamples and calibration curves. External evaluation was conducted on a validation cohort using ROC curves and H-L tests. The modeling cohort included 420 patients, with an IH rate of 39.8%. Univariate and multivariate logistic regression showed that baseline temperature (odds ratio [OR] = 0.087), preoperative psychological score (OR = 1.114), body mass index (BMI) (OR = 0.820), and anesthesia time (OR = 1.013) were independent risk factors for IH. The ROC curve of the Nomogram had an area under the curve of 0.844 (95% confidence interval [CI]: 0.807-0.881), a maximum Youden index of 0.563, a best cutoff value of 0.383, a sensitivity of 0.772, and a specificity of 0.791. The H-L test yielded a chi-square value of 10.173 and a <i>p</i>-value of 0.253. Internal validation with 1000 Bootstrap resamples showed a consistency coefficient of 0.844, the calibration curve fits well. A total of 120 patients were included in the validation cohort, including 45 with hypothermia (37.5%). The area under the ROC curve for the prediction of IH in the external validation cohort was 0.854 (95% CI: 0.781-0.927), and the H-L test yielded a chi-square value of 5.207 and a <i>p</i>-value of 0.735. The IH rate is high in elderly patients undergoing RAUTR. Baseline temperature, preoperative psychological score, BMI, and anesthesia time are independent risk factors. And the Nomogram could be used to predict IH.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Prognostic Findings in Newborns with Hypoxic Ischemic Encephalopathy: 5-Year Experience.","authors":"Ozlem Sahin, Derya Colak, Funda Yavanoglu Atay, Omer Guran, Ilke Mungan Akin","doi":"10.1089/ther.2025.0011","DOIUrl":"10.1089/ther.2025.0011","url":null,"abstract":"<p><p>Hypoxic-ischemic encephalopathy (HIE) is a constellation of neurological signs as a result of hypoxia, hypercapnia, metabolic acidosis, and cerebral ischemia before birth. The aim was to evaluate risk factors, clinical and laboratory findings, and morbidity and mortality in neonates diagnosed with HIE who underwent therapeutic hypothermia (TH). Between January 2015 and December 2020, neonates diagnosed with HIE were evaluated in the neonatal intensive care unit. Risk factors, sociodemographic characteristics, degree of encephalopathy, clinical and laboratory findings, results of amplitude-integrated electroencephalography (aEEG), electroencephalography (EEG), magnetic resonance imaging (MRI) including diffusion weighted imaging (DWI) and cranial ultrasound (cUS), and mortality were retrospectively recorded. Of the 81 cases, we followed up with a diagnosis of HIE. When the patients were divided into groups and evaluated according to the Sarnat & Sarnat staging system, it was observed that 22 (27.2%) of the patients had mild HIE, 49 (60.5%) of the patients had moderate HIE, and 10 (12.3%) of the patients had severe HIE. The aEEG, EEG, DWI, and renal pathology of patients with seizures were statistically significantly higher than those of patients without seizures (<i>p</i> = 0.004, <i>p</i> = 0.002, <i>p</i> = 0.014, <i>p</i> = 0.025). MRI was performed in 66 patients within the first 7 days of life, and diffusional restriction was found in 22 of them. We found that DWI is superior to cUS in determining the severity of hypoxic injury and that renal involvement may be associated with poor neurodevelopmental outcomes. Due to the abnormal prognostic findings detected in infants with mild HIE, the existence of a standard definition of mild HIE that will determine the efficacy and reliability of therapeutic hypothermia will enable at risk infants to benefit from neuroprotective strategies.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"97-103"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Time to Initiation of Targeted Temperature Management Among Patients with Out-of-Hospital Cardiac Arrest Undergoing Percutaneous Coronary Intervention.","authors":"Christopher P Kovach, Jan Leonard, John C Messenger, Stephen W Waldo, Sarah M Perman","doi":"10.1089/ther.2024.0030","DOIUrl":"10.1089/ther.2024.0030","url":null,"abstract":"<p><p>Delays in initiation of targeted temperature management (TTM) have been observed in randomized trials evaluating immediate or delayed coronary angiography among survivors of ventricular tachycardia (VT) or ventricular fibrillation (VF) out-of-hospital cardiac arrest (OHCA), but whether delays are associated with adverse clinical outcomes is unknown. Resuscitated survivors of VT/VF OHCA who received TTM between April 2011 and June 2015 were identified and time to TTM initiation was described. The association between TTM initiation <2 versus ≥2 hours, neurologically favorable, and overall survival to hospital discharge was assessed. In a propensity-weighted analysis of 2954 patients, a significantly larger proportion of patients undergoing percutaneous coronary intervention (PCI) had TTM initiation ≥2 hours (48.6%) as compared to patients undergoing angiography (41.4%) or those who did not undergo a procedure (33.0%; <i>p</i> < 0.001 for all comparisons). In this cohort, the odds of neurologically favorable survival (odds ratios [OR]: 0.88, 95% confidence intervals [CI] = 0.75-1.02) and overall survival (OR: 0.92, 95% CI = 0.83-1.03) to hospital discharge were similar among ST-elevation myocardial infarction (STEMI) patients who underwent PCI with TTM initiation <2 versus ≥2 hours. Patients without STEMI who underwent PCI with TTM initiation ≥2 hours and did not have a \"do not resuscitate\" order or withdrawal of life-sustaining care had decreased odds of neurologically favorable survival to hospital discharge (OR: 0.45, 95% CI = 0.22-0.93) compared to TTM initiation <2 hours. PCI was associated with delays in TTM initiation ≥2 hours among resuscitated survivors of VT/VF OHCA. Delays in TTM initiation ≥2 hours were associated with decreased odds of neurologically favorable survival among patients without STEMI who underwent PCI.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"74-81"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between the Rewarming Duration and Neurological Outcomes after Extracorporeal Cardiopulmonary Resuscitation Followed by Targeted Temperature Management for Out-of-Hospital Cardiac Arrests: A Secondary Analysis of the SAVE-J II Study.","authors":"Sohma Miyamoto, Toru Hifumi, Akira Komori, Hiroki Iriyama, Toshikazu Abe, Akihiko Inoue, Tetsuya Sakamoto, Yasuhiro Kuroda, Norio Otani","doi":"10.1089/ther.2024.0036","DOIUrl":"10.1089/ther.2024.0036","url":null,"abstract":"<p><p>There are no studies examining the association between rewarming durations and neurological outcomes after extracorporeal cardiopulmonary resuscitation (ECPR) followed by targeted temperature management (TTM) for patients with out-of-hospital cardiac arrest (OHCA). This study aimed to examine the association between rewarming durations and neurological outcomes after ECPR with TTM for patients with OHCA. This was a secondary analysis of the Advanced Life Support Study Registry for Ventricular Fibrillation with Extracorporeal Circulation in Japan study, a retrospective, multicenter study. Patients with OHCA who underwent ECPR and completed a TTM of 34°C and <34°C were included. Favorable neurological outcomes (cerebral performance categories 1-2) and survival upon hospital discharge were the primary outcomes. In total, 407 patients were included, with favorable neurological outcomes upon hospital discharge in 106 patients. The numbers of patients with rewarming durations of <24 hours, 24 hours, and >24 hours were 178, 133, and 96, respectively. In the multivariable analysis, a rewarming duration of <24 hours was not significantly associated with favorable neurological outcomes [odds ratio (OR): 1.06, 95% confidence interval (CI): 0.60-1.87, <i>p</i> = 0.84] or survival (OR: 0.96, 95% CI: 0.58-1.57, <i>p</i> = 0.86) compared with that of 24 hours, and that of <24 hours was not significantly associated with favorable neurological outcomes (OR: 0.74, 95% CI: 0.40-1.71, <i>p</i> = 0.56) or survival (OR: 0.74, 95% CI: 0.42-1.28, <i>p</i> = 0.38) than that of >24 hours. A rewarming duration of <24 hours in TTM after ECPR for OHCA was not significantly associated with favorable neurological outcomes or survival than that of 24 hours or >24 hours.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"89-96"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}