For a study, researchers sought to determine whether or not Targeted temperature management at 33 °C (TTM33) was linked to an increased risk of mortality in individuals who required vasopressor support upon admission following out-of-hospital cardiac arrest (OHCA). Investigators carried out a post hoc analysis on the patients who participated in the TTM-2 trial, a global, multicenter study that compared the effects of TTM33 and normothermia on the outcomes of adult patients who had suffered an OHCA while they were unconscious. Patients were divided into 3 categories based on the amount of circulatory support they required at the time of admission: no-vasopressor support, mean arterial blood pressure (MAP) more than or equal to 70 mmHg; moderate-vasopressor support, MAP less than 70 mmHg or any dose of dopamine/dobutamine or noradrenaline/adrenaline dose of less than or equal to 0.25 µg/kg/min; and high-vasopressor support, noradrenaline/adrenaline dose of more than 0.25 µg/kg/min. The 180-day death rate from all causes was used in calculating the TTM33 hazard ratios for these categories. About 1,900 participants participated in the TTM-2 experiment. There was data available for 1,850 patients, with 662 patients in the no-vasopressor support group, 896 patients in the moderate-vasopressor support group, and 292 patients in the high-vasopressor support group. Concerning TTM33, the hazard ratio for 180-day mortality was 1.04 [98.3% CI 0.78–1.39], 1.22 [98.3% CI 0.97–1.53], and 0.97 [98.3% CI 0.68–1.38] in the no, moderate, and high-vasopressor support groups, respectively. An imputed and adjusted sensitivity analysis showed no significant differences in the results. The exploratory study found that maintaining a temperature of 33 degrees Celsius following an OHCA, as opposed to normothermia, was not related to a higher rate of death in patients who were stratified according to whether or not they required vasopressor support upon admission.
Source – ccforum.biomedcentral.com/articles/10.1186/s13054-022-04107-9
