Magnetic resonance imaging in comatose adults resuscitated after out-of-hospital cardiac arrest: A posthoc study of the Targeted Therapeutic Mild Hypercapnia after Resuscitated Cardiac Arrest trial.

IF 2.6 3区 医学 Q2 CRITICAL CARE MEDICINE Australian Critical Care Pub Date : 2024-11-07 DOI:10.1016/j.aucc.2024.09.015
Glenn M Eastwood, Michael Bailey, Alistair D Nichol, Josef Dankiewicz, Niklas Nielsen, Rachael Parke, Tobias Cronberg, Theresa Olasveengen, Anders M Grejs, Manuela Iten, Matthias Haenggi, Peter McGuigan, Franca Wagner, Marion Moseby-Knappe, Margareta Lang, Rinaldo Bellomo
{"title":"Magnetic resonance imaging in comatose adults resuscitated after out-of-hospital cardiac arrest: A posthoc study of the Targeted Therapeutic Mild Hypercapnia after Resuscitated Cardiac Arrest trial.","authors":"Glenn M Eastwood, Michael Bailey, Alistair D Nichol, Josef Dankiewicz, Niklas Nielsen, Rachael Parke, Tobias Cronberg, Theresa Olasveengen, Anders M Grejs, Manuela Iten, Matthias Haenggi, Peter McGuigan, Franca Wagner, Marion Moseby-Knappe, Margareta Lang, Rinaldo Bellomo","doi":"10.1016/j.aucc.2024.09.015","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Neuroimaging with magnetic resonance imaging (MRI) may assist clinicians in evaluating brain injury and optimising care in comatose adults resuscitated after out-of-hospital cardiac arrest (OHCA). However, contemporary international data on its use are lacking.</p><p><strong>Aim: </strong>The primary aim was to compare the patient characteristics, early postresuscitation care, and neurological outcomes of patients according to MRI use.</p><p><strong>Methods: </strong>We performed a posthoc analysis of the Targeted Therapeutic Mild Hypercapnia after Resuscitated Cardiac Arrest (TAME) trial, a multinational randomised trial comparing targeted mild hypercapnia or normocapnia in comatose adults after OHCA.</p><p><strong>Results: </strong>After exclusions, 1639 patients enrolled in the TAME trial were analysed. Of these, 149 (9%) had an MRI. Compared to non-MRI patients, MRI patients were younger (58.9 versus 61.7 years, p: 0.02), had a longer median time from OHCA to return of spontaneous circulation (30 versus 25 min, p < 0.0001), and had a higher average arterial lactate level (8.78 versus 6.74 mmol/L, p < 0.0001) on admission to hospital. MRI patients were more likely to receive additional advanced diagnostic assessments during intensive care unit admission (p < 0.0001). At 6 months, 23 of 140 patients (16.4%) in the MRI group had a favourable neurological outcome, compared with 659 of 1399 patients (47.1%) in the no-MRI group (p < 0.001). On multivariable modelling, country of enrolment was the dominating predictor in the likelihood of an MRI being performed.</p><p><strong>Conclusions: </strong>In the TAME trial, 9% of patients had an MRI during their intensive care unit admission. Among these patients, only 16% had a favourable neurological outcome at 6 months.</p>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":" ","pages":"101130"},"PeriodicalIF":2.6000,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australian Critical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.aucc.2024.09.015","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Neuroimaging with magnetic resonance imaging (MRI) may assist clinicians in evaluating brain injury and optimising care in comatose adults resuscitated after out-of-hospital cardiac arrest (OHCA). However, contemporary international data on its use are lacking.

Aim: The primary aim was to compare the patient characteristics, early postresuscitation care, and neurological outcomes of patients according to MRI use.

Methods: We performed a posthoc analysis of the Targeted Therapeutic Mild Hypercapnia after Resuscitated Cardiac Arrest (TAME) trial, a multinational randomised trial comparing targeted mild hypercapnia or normocapnia in comatose adults after OHCA.

Results: After exclusions, 1639 patients enrolled in the TAME trial were analysed. Of these, 149 (9%) had an MRI. Compared to non-MRI patients, MRI patients were younger (58.9 versus 61.7 years, p: 0.02), had a longer median time from OHCA to return of spontaneous circulation (30 versus 25 min, p < 0.0001), and had a higher average arterial lactate level (8.78 versus 6.74 mmol/L, p < 0.0001) on admission to hospital. MRI patients were more likely to receive additional advanced diagnostic assessments during intensive care unit admission (p < 0.0001). At 6 months, 23 of 140 patients (16.4%) in the MRI group had a favourable neurological outcome, compared with 659 of 1399 patients (47.1%) in the no-MRI group (p < 0.001). On multivariable modelling, country of enrolment was the dominating predictor in the likelihood of an MRI being performed.

Conclusions: In the TAME trial, 9% of patients had an MRI during their intensive care unit admission. Among these patients, only 16% had a favourable neurological outcome at 6 months.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
院外心脏骤停复苏后昏迷成人的磁共振成像:心脏骤停复苏后目标治疗性轻度高碳酸血症试验的事后研究。
背景:使用磁共振成像(MRI)进行神经成像可帮助临床医生评估脑损伤并优化院外心脏骤停(OHCA)后昏迷成人复苏后的护理。目的:主要目的是根据核磁共振成像的使用情况,比较患者的特征、复苏后早期护理和神经系统预后:我们对心脏骤停复苏后目标性治疗性轻度高碳酸血症(TAME)试验进行了事后分析,该试验是一项跨国随机试验,对 OHCA 后昏迷的成人进行了目标性轻度高碳酸血症或正常碳酸血症的比较:结果:在排除其他因素后,对参加 TAME 试验的 1639 名患者进行了分析。其中149人(9%)进行了核磁共振成像。与非核磁共振成像患者相比,核磁共振成像患者更年轻(58.9 岁对 61.7 岁,P:0.02),从 OHCA 到恢复自主循环的中位时间更长(30 分钟对 25 分钟,P:0.01):在 TAME 试验中,9% 的患者在入住重症监护病房期间接受了核磁共振成像检查。在这些患者中,只有 16% 的患者在 6 个月后获得了良好的神经功能预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Australian Critical Care
Australian Critical Care NURSING-NURSING
CiteScore
4.90
自引率
9.10%
发文量
148
审稿时长
>12 weeks
期刊介绍: Australian Critical Care is the official journal of the Australian College of Critical Care Nurses (ACCCN). It is a bi-monthly peer-reviewed journal, providing clinically relevant research, reviews and articles of interest to the critical care community. Australian Critical Care publishes peer-reviewed scholarly papers that report research findings, research-based reviews, discussion papers and commentaries which are of interest to an international readership of critical care practitioners, educators, administrators and researchers. Interprofessional articles are welcomed.
期刊最新文献
Prevalence and risk factors associated within 48-hour unplanned paediatric intensive care unit readmissions: An integrative review. Comparison of Glasgow Coma Scale and Full Outline of UnResponsiveness score to assess the level of consciousness in patients admitted to intensive care units and emergency departments: A quantitative systematic review. Use of point-of-care ultrasound during cardiac arrest in the intensive care unit: A cross-sectional survey. The influence of anxiety and depression on critical care nurses' performance: A multicenter correlational study. Patients' and relatives' experiences of cognitive impairment following an intensive care unit admission. A qualitative study.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1