The association between neuromuscular blockade use during target temperature management and neurological outcomes - 29/07/21
, Akihiko Inoue b, c, 1, Hideki Arimoto d, Naohiro Yonemoto e, Yasuhiro Kuroda b, Yoshio Tahara f, Kenya Kawakita b, Hiroyuki Yokoyama g, Ken Nagao h, Hiroshi Nonogi ithe J-PULSE-Hypo Investigators
Abstract |
Background |
To date, no study has comprehensively analyzed the association between neuromuscular blockade (NMB) during target temperature management (TTM) and the neurological outcomes after out-of-hospital cardiac arrest (OHCA) using a multicenter dataset. We aimed to examine the association between NMB during TTM after cardiac arrest and neurological outcomes after OHCA.
Methods |
This study was a secondary analysis of the Japanese Population-based Utstein-style study with defibrillation and basic/advanced Life Support Education and implementation-Hypothermia (J-PULSE-HYPO) study registry. The exposure of the current study was the use of NMB during TTM. The primary outcome was favorable neurological outcome, i.e., a cerebral performance category of 1–2, at hospital discharge.
Results |
Of the 452 patients with OHCA enrolled in the J-PULSE-HYPO study, 431 were analyzed. NMB was used in 353 patients (81.9%). Multivariable logistic regression analysis revealed that NMB use was not independently associated with favorable outcomes [odds ratio (OR), 0.96; 95% confidence interval (CI), 0.42–2.18; p = .918)] or survival at discharge (OR, 0.83; 95% CI, 0.31–2.02; p = .688). After adjusting the covariates, the predicted probabilities did not reveal significant differences between NMB use and non-NMB use in the respective mean (95% CI) values for favorable neurological outcomes [53.6 (50.2–57.0) % vs. 58.0 (50.4–65.6) %, p = .304], and survival rates [77.1 (74.7–79.5) % vs. 75.8 (70.5–81.0) %, p = .647].
Conclusions |
The NMB use during TTM was not associated with favorable neurological outcomes and survival rate in patients with OHCA.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Of all study participants, 81.9% received NMB during TTM. |
• | Of the included patients, 77.0% survived until hospital discharge, of which 55.2% had favorable neurological outcome. |
• | The NMB use during TTM was not associated with favorable neurological outcomes, or survival in patients with OHCA. |
Keywords : Neuromuscular blockade, Out-of-hospital cardiac arrest, Target temperature management
Plan
Vol 46
P. 289-294 - août 2021 Retour au numéro
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