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Differential Effectiveness of Hypothermic Targeted Temperature Management According to the Severity of Post-Cardiac Arrest Syndrome

International guidelines recommend targeted temperature management (TTM) to improve the neurological outcomes in adult patients with post-cardiac arrest syndrome (PCAS). However, it still remains unclear if the lower temperature setting (hypothermic TTM) or higher temperature setting (normothermic T...

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Autores principales: Kikutani, Kazuya, Nishikimi, Mitsuaki, Shimatani, Tatsutoshi, Kyo, Michihito, Ohshimo, Shinichiro, Shime, Nobuaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658523/
https://www.ncbi.nlm.nih.gov/pubmed/34884345
http://dx.doi.org/10.3390/jcm10235643
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author Kikutani, Kazuya
Nishikimi, Mitsuaki
Shimatani, Tatsutoshi
Kyo, Michihito
Ohshimo, Shinichiro
Shime, Nobuaki
author_facet Kikutani, Kazuya
Nishikimi, Mitsuaki
Shimatani, Tatsutoshi
Kyo, Michihito
Ohshimo, Shinichiro
Shime, Nobuaki
author_sort Kikutani, Kazuya
collection PubMed
description International guidelines recommend targeted temperature management (TTM) to improve the neurological outcomes in adult patients with post-cardiac arrest syndrome (PCAS). However, it still remains unclear if the lower temperature setting (hypothermic TTM) or higher temperature setting (normothermic TTM) is superior for TTM. According to the most recent large randomized controlled trial (RCT), hypothermic TTM was not found to be associated with superior neurological outcomes than normothermic TTM in PCAS patients. Even though this represents high-quality evidence obtained from a well-designed large RCT, we believe that we still need to continue investigating the potential benefits of hypothermic TTM. In fact, several studies have indicated that the beneficial effect of hypothermic TTM differs according to the severity of PCAS, suggesting that there may be a subgroup of PCAS patients that is especially likely to benefit from hypothermic TTM. Herein, we summarize the results of major RCTs conducted to evaluate the beneficial effects of hypothermic TTM, review the recent literature suggesting the possibility that the therapeutic effect of hypothermic TTM differs according to the severity of PCAS, and discuss the potential of individualized TTM.
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spelling pubmed-86585232021-12-10 Differential Effectiveness of Hypothermic Targeted Temperature Management According to the Severity of Post-Cardiac Arrest Syndrome Kikutani, Kazuya Nishikimi, Mitsuaki Shimatani, Tatsutoshi Kyo, Michihito Ohshimo, Shinichiro Shime, Nobuaki J Clin Med Review International guidelines recommend targeted temperature management (TTM) to improve the neurological outcomes in adult patients with post-cardiac arrest syndrome (PCAS). However, it still remains unclear if the lower temperature setting (hypothermic TTM) or higher temperature setting (normothermic TTM) is superior for TTM. According to the most recent large randomized controlled trial (RCT), hypothermic TTM was not found to be associated with superior neurological outcomes than normothermic TTM in PCAS patients. Even though this represents high-quality evidence obtained from a well-designed large RCT, we believe that we still need to continue investigating the potential benefits of hypothermic TTM. In fact, several studies have indicated that the beneficial effect of hypothermic TTM differs according to the severity of PCAS, suggesting that there may be a subgroup of PCAS patients that is especially likely to benefit from hypothermic TTM. Herein, we summarize the results of major RCTs conducted to evaluate the beneficial effects of hypothermic TTM, review the recent literature suggesting the possibility that the therapeutic effect of hypothermic TTM differs according to the severity of PCAS, and discuss the potential of individualized TTM. MDPI 2021-11-30 /pmc/articles/PMC8658523/ /pubmed/34884345 http://dx.doi.org/10.3390/jcm10235643 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Kikutani, Kazuya
Nishikimi, Mitsuaki
Shimatani, Tatsutoshi
Kyo, Michihito
Ohshimo, Shinichiro
Shime, Nobuaki
Differential Effectiveness of Hypothermic Targeted Temperature Management According to the Severity of Post-Cardiac Arrest Syndrome
title Differential Effectiveness of Hypothermic Targeted Temperature Management According to the Severity of Post-Cardiac Arrest Syndrome
title_full Differential Effectiveness of Hypothermic Targeted Temperature Management According to the Severity of Post-Cardiac Arrest Syndrome
title_fullStr Differential Effectiveness of Hypothermic Targeted Temperature Management According to the Severity of Post-Cardiac Arrest Syndrome
title_full_unstemmed Differential Effectiveness of Hypothermic Targeted Temperature Management According to the Severity of Post-Cardiac Arrest Syndrome
title_short Differential Effectiveness of Hypothermic Targeted Temperature Management According to the Severity of Post-Cardiac Arrest Syndrome
title_sort differential effectiveness of hypothermic targeted temperature management according to the severity of post-cardiac arrest syndrome
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658523/
https://www.ncbi.nlm.nih.gov/pubmed/34884345
http://dx.doi.org/10.3390/jcm10235643
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