論文

国際誌
2018年7月

Differential effect of mild therapeutic hypothermia depending on the findings of hypoxic encephalopathy on early CT images in patients with post-cardiac arrest syndrome.

Resuscitation
  • Mitsuaki Nishikimi
  • ,
  • Takayuki Ogura
  • ,
  • Kazuki Nishida
  • ,
  • Kunihiko Takahashi
  • ,
  • Kenji Fukaya
  • ,
  • Keibun Liu
  • ,
  • Mitsunobu Nakamura
  • ,
  • Shigeyuki Matsui
  • ,
  • Naoyuki Matsuda

128
開始ページ
11
終了ページ
15
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.resuscitation.2018.04.029

INTRODUCTION: The aim of this study was to evaluate the differential effects of mild therapeutic hypothermia (MTH) in post-cardiac arrest syndrome (PCAS) patients depending on the presence/absence of hypoxic encephalopathy (HE) in the early brain CT images obtained before the initiation of MTH. METHODS: We conducted a retrospective review of the data of a total of 129 patients with PCAS who were treated by MTH (34 °C) or normothermia treatment (NT) (35 °C or 36 °C), and had undergone brain CT examination prior to the initiation of these treatments. We divided the subjects into 4 groups, namely, the HE(-)/MTH, HE(-)/NT, HE(+)/MTH, and HE(+)/NT groups, for evaluating the interaction effect between the two variables. Then, we compared the neurological outcomes between the HE(-)/MTH and HE(-)/NT groups by multivariate logistic analysis. Good outcome was defined as a Cerebral Performance Category score of ≤2 at 30 days. RESULTS: The percentages of subjects with a good outcome in the HE(-)/MTH and HE(-)/NT group were 68.9% (42/61) and 36.1% (13/36), respectively (p = .003), while those in the HE(+)/MTH and HE(+)/NT groups were lower, at 7.4% (2/27) and 20.0% (1/5), respectively (p = .410), suggesting a statistically significant interaction effect between the two variables (pinteraction = 0.002). In the HE(-) group, MTH was associated with a higher odds ratio of a good outcome as compared to NT (OR 6.80, 95% CI 1.19-38.96, p = .031). CONCLUSIONS: The effect of MTH in patients with PCAS differed depending on the presence/absence of evidence of HE on the early CT images.

リンク情報
DOI
https://doi.org/10.1016/j.resuscitation.2018.04.029
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/29698752
ID情報
  • DOI : 10.1016/j.resuscitation.2018.04.029
  • ISSN : 0300-9572
  • PubMed ID : 29698752

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