CLINICAL FEATURES AND SHORT-TERM OUTCOMES IN COMATOSE SURVIVORS OF OUT-OF-HOSPITAL CARDIAC ARREST UNDERGOING TARGETED TEMPERATURE MANAGEMENT
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Abstract
Background: Comatose patients following out-of-hospital cardiac arrest (OHCA) have poor prognoses, with high rates of mortality and neurological sequelae. Targeted Temperature Management (TTM) is one of the key interventions to improve neurological outcomes after successful cardiopulmonary resuscitation (CPR).
Objective: To describe the clinical characteristics and short-term outcomes of comatose OHCA patients treated with TTM.
Methods: A prospective descriptive study conducted at an intensive care unit on patients remaining comatose after return of spontaneous circulation (ROSC), treated with TTM between 2021 and 2023. The primary outcome was 30-day survival and neurological recovery.
Results: A total of 51 patients were included. Bystander CPR rate was low (13.7%). The 30-day survival rate was 27.5%, with 57.1% of survivors achieving good neurological recovery. Factors associated with mortality included prolonged time from cardiac arrest to ROSC (>20 minutes), low Glasgow Coma Scale score, and elevated serum creatinine at admission (p<0.05). The median time for the initiation of TTM was 17 hours. Most patients were cooled via intravascular catheters. Common complications during TTM included shivering, electrolyte disturbances, and hyperglycemia.
Conclusion: Targeted Temperature Management is a feasible therapeutic strategy with potential to improve neurological outcomes in OHCA patients in Vietnam. Early recognition improved prehospital care, and earlier initiation of TTM are essential to enhance treatment effectiveness.
Keywords
Out-of-hospital cardiac arrest, targeted temperature management, neurological outcome
Article Details
References
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