Results of targeted temperature management of patients after sudden out­of­hospital cardiac arrest: a comparison between intensive general and cardiac care units.

ABSTRACT

BACKGROUND: Targeted temperature management (TTM) is used to treat patients after sudden out­of­hospital cardiac arrest (OHCA). AIMS: The aim of the study was to compare the results of TTM between intensive general and cardiac care units (ICCUs). METHODS: The Polish Registry of Therapeutic Hypothermia obtained data on 377 patients with OHCA from 26 centers (257 and 120 patients treated at the ICCU and intensive care unit [ICU], respectively). Eligibility for TTM was based on the current inclusion criteria for therapy. Medical history as well as data on TTM and additional treatment were analyzed. The main outcomes included in­hospital survival and complications as well as neurologic assessment using the Glasgow Coma Scale (GCS) and Rankin scale. RESULTS: Both ICU and ICCU patients were mostly male (mean age, 60 years). There were no significant differences regarding the medical history, mechanism of arrhythmia responsible for OHCA, GCS score on admission, time of cardiopulmonary resuscitation activities, and the time to target temperature (33°C). Coronary angiography and the use of dual antiplatelet therapy, intra­aortic balloon pump, intravascular hypothermia, dopamine, and dobutamine were more common in ICCU patients, while ICU patients more often received norepinephrine. Pneumonia and acute renal failure were more frequent in the ICCU group. Death occurred in 17% and 20% of ICU and ICCU patients, respectively (P = 0.57). The Rankin class after 48 hours since discontinuation of sedation and at discharge was comparable between groups. CONCLUSIONS: The ICCU has become a considerable alternative to the ICU to treat OHCA patients with TTM.