Targeted Temperature Management Experience of an Academic Emergency Department: A 5-Year Retrospective Study

Ozdamar Y., Agackiran I., METİN AKSU N.

THERAPEUTIC HYPOTHERMIA AND TEMPERATURE MANAGEMENT, cilt.12, sa.3, ss.171-176, 2022 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 12 Sayı: 3
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1089/ther.2021.0028
  • Dergi Adı: THERAPEUTIC HYPOTHERMIA AND TEMPERATURE MANAGEMENT
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.171-176
  • Anahtar Kelimeler: targeted temperature management, emergency department, organ donation, EUROPEAN RESUSCITATION COUNCIL, AMERICAN-HEART-ASSOCIATION, THERAPEUTIC HYPOTHERMIA, CARDIAC-ARREST, CARE, CARDIOPULMONARY, GUIDELINES, IMPROVE
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Targeted temperature management (TTM) for postcardiac arrest syndrome patients is a cornerstone therapy to reduce mortality and neurological morbidity. The care of critical patients is provided in the emergency department (ED) when intensive care units (ICUs) are unavailable. This study aimed to determine the characteristics and mortality outcomes of postcardiac arrest patients who underwent TTM in an academic ED. Postcardiac arrest patients who underwent TTM between January 1, 2014, to November 1, 2018, at a tertiary care academic ED in Turkey were examined retrospectively. The mean age of 24 patients in whom TTM was initiated in the ED was 60.7 +/- 19.2 years. Five (20.8%) of the patients who underwent TTM were discharged. Four (80%) of the discharged patients were in out-of-hospital cardiac arrest (OHCA). All patients with a total cardiopulmonary resuscitation duration of >25 minutes died. Mortality was significantly higher in patients without light reflexes (p = 0.006). Two patients who underwent TTM in the ED became organ donors after neurological determination of death. If the ICU cannot meet the needs, early initiation of TTM in the ED may contribute to good neurological outcomes. In this study, 80% of the patients who have positive neurological outcomes are OHCA. Lack of light reflex may be an evidence of poor neurological outcomes in postcardiac arrest patients. Emergency physicians should be encouraged to apply TTM.