Analysis of possible factors affecting neurologic outcomes of resuscitated cardiac arrest patients with initial non-shockable rhythm after targeted temperature management.

Abstract

Background: To identify the possible factors correlated with the outcomes of initial non-shockable rhythm cardiac arrest patients who received target temperature management (TTM).

Materials and methods: We utilized the Taiwan Network of Targeted Temperature ManagEment for CARDiac Arrest (TIMECARD) registry and selected patients with initial non-shockable rhythm as the study group from the registry. The primary outcome was a favorable neurologic outcome. Univariate and multivariate analyses were performed to identify significant variables.

Results: A total of 332 patients with initial non-shockable rhythm were selected. The factors significantly affecting neurologic outcome were pre-arrest CPC 1, in-hospital cardiac arrest event, an initial rhythm of PEA, received bystander cardiopulmonary resuscitation (CPR), a shorter CPR duration, a higher systolic blood pressure at return of spontaneous circulation (ROSC), a higher diastolic blood pressure (DBP) at ROSC, without new-onset seizure, experience of hypokalemia, and received percutaneous coronary intervention. The results of multivariate analysis revealed that patients with initial rhythm of PEA, higher DBP, without new-onset seizure, and experience of hypokalemia were associated with better neurologic outcome.

Conclusions: Initial non-shockable cardiac arrest patients who had initial rhythm of PEA, higher DBP at ROSC, hypokalemia but no new-onset seizure may be correlated to better neurologic outcome after TTM.

Trial registration:

Clinicaltrials: gov: NCT03578328.