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

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.

Conclusion

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.