The association between neuromuscular blockade use during target temperature management and neurological outcomes
| Autor: | Kenya Kawakita, Toru Hifumi, Yasuhiro Kuroda, Naohiro Yonemoto, Yoshio Tahara, Akihiko Inoue, Hideki Arimoto, Ken Nagao, Hiroyuki Yokoyama, J-PULSE-Hypo Investigators, Hiroshi Nonogi |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Defibrillation medicine.medical_treatment Logistic regression 03 medical and health sciences 0302 clinical medicine Japan Hypothermia Induced Internal medicine medicine Humans Survival rate Aged Neuromuscular Blockade Study Registry business.industry 030208 emergency & critical care medicine General Medicine Odds ratio Middle Aged Confidence interval Advanced life support Survival Rate Emergency Medicine Female Nervous System Diseases business Out-of-Hospital Cardiac Arrest |
| Zdroj: | The American journal of emergency medicine. 46 |
| ISSN: | 1532-8171 |
| Popis: | Background To date, no study has comprehensively analyzed the association between neuromuscular blockade (NMB) during target temperature management (TTM) and the neurological outcomes after out-of-hospital cardiac arrest (OHCA) using a multicenter dataset. We aimed to examine the association between NMB during TTM after cardiac arrest and neurological outcomes after OHCA. Methods This study was a secondary analysis of the Japanese Population-based Utstein-style study with defibrillation and basic/advanced Life Support Education and implementation-Hypothermia (J-PULSE-HYPO) study registry. The exposure of the current study was the use of NMB during TTM. The primary outcome was favorable neurological outcome, i.e., a cerebral performance category of 1–2, at hospital discharge. Results Of the 452 patients with OHCA enrolled in the J-PULSE-HYPO study, 431 were analyzed. NMB was used in 353 patients (81.9%). Multivariable logistic regression analysis revealed that NMB use was not independently associated with favorable outcomes [odds ratio (OR), 0.96; 95% confidence interval (CI), 0.42–2.18; p = .918)] or survival at discharge (OR, 0.83; 95% CI, 0.31–2.02; p = .688). After adjusting the covariates, the predicted probabilities did not reveal significant differences between NMB use and non-NMB use in the respective mean (95% CI) values for favorable neurological outcomes [53.6 (50.2–57.0) % vs. 58.0 (50.4–65.6) %, p = .304], and survival rates [77.1 (74.7–79.5) % vs. 75.8 (70.5–81.0) %, p = .647]. Conclusions The NMB use during TTM was not associated with favorable neurological outcomes and survival rate in patients with OHCA. |
| Databáze: | OpenAIRE |
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