Objective Cerebral hemodynamic and metabolic changes may occur during the rewarming phase of targeted temperature management in post cardiac arrest patients. Yet, studies on different rewarming rates and patient outcomes are limited. This study aimed to investigate post cardiac arrest patients who were rewarmed with different rewarming rates after 24 hours of hypothermia and the association of these rates to the neurologic outcomes.
Methods This study retrospectively investigated post cardiac arrest patients treated with targeted temperature management and rewarmed with rewarming rates of 0.15°C/hr and 0.25°C/hr. The association of the rewarming rate with poor neurologic outcomes (cerebral performance category score, 3 to 5) was investigated.
Results A total of 71 patients were analyzed (0.15°C/hr, n=36; 0.25°C/hr, n=35). In the comparison between 0.15°C/hr and 0.25°C/hr, the poor neurologic outcome did not significantly differ (24 [66.7%] vs. 25 [71.4%], respectively; P=0.66). In the multivariate analysis, the rewarming rate of 0.15°C/hr was not associated with the 1-month neurologic outcome improvement (odds ratio, 0.54; 95% confidence interval, 0.16 to 1.69; P=0.28).
Conclusion The rewarming rates of 0.15°C/hr and 0.25°C/hr were not associated with the neurologic outcome difference in post cardiac arrest patients.
Citations
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Association Between Rewarming Rate and Survival and Neurologic Outcome of Accidental Hypothermia Chiaki Hara, Takuya Taira, Akihiko Inoue, Takeshi Nishimura, Shota Kikuta, Nobuhiro Yamamoto, Shinichi Ijuin, Shuhei Takauji, Mineji Hayakawa, Satoshi Ishihara Critical Care Medicine.2025; 53(7): e1416. CrossRef
Temperature Control After Cardiac Arrest: A Narrative Review Samantha Fernandez Hernandez, Brooke Barlow, Vera Pertsovskaya, Carolina B. Maciel Advances in Therapy.2023; 40(5): 2097. CrossRef
Rapid rewarming rate associated with favorable neurological outcomes in patients with post–cardiac arrest syndrome patients treated with targeted temperature management Masaru Shin, Motoki Fujita, Toru Hifumi, Yasutaka Koga, Takeshi Yagi, Takashi Nakahara, Masaki Todani, Kotaro Kaneda, Ryosuke Tsuruta Acute Medicine & Surgery.2023;[Epub] CrossRef
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Impact of rewarming rate on interleukin-6 levels in patients with shockable cardiac arrest receiving targeted temperature management at 33 °C: the ISOCRATE pilot randomized controlled trial Jean-Baptiste Lascarrou, Elie Guichard, Jean Reignier, Amélie Le Gouge, Caroline Pouplet, Stéphanie Martin, Jean-Claude Lacherade, Gwenhael Colin, M. Azais, K. Bachoumas, A. Bailly, L. Camous, G. Colin, L. Crosby, M. Fiancette, M. Henry Lagarrigue, J. C. Critical Care.2021;[Epub] CrossRef
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High Quality Targeted Temperature Management (TTM) After Cardiac Arrest Fabio Silvio Taccone, Edoardo Picetti, Jean-Louis Vincent Critical Care.2020;[Epub] CrossRef
Resuscitating the Globally Ischemic Brain: TTM and Beyond Melika Hosseini, Robert H. Wilson, Christian Crouzet, Arya Amirhekmat, Kevin S. Wei, Yama Akbari Neurotherapeutics.2020; 17(2): 539. CrossRef
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Objective This study was performed to investigate the effect of the rewarming rate on survival and acute lung injury in sepsis.
Methods Male Sprague-Dawley rats underwent cecal ligation and incision. After 1 hour of sepsis induction, normothermia (37°C±0.5°C, NT group) or hypothermia (32°C±0.5°C) was induced. Hypothermia was maintained for 4 hours and rats were divided into two groups according to the rewarming rate: RW1 group, 1 hour of rewarming; and RW2 group, 2 hours of rewarming. In the survival study, rats were observed for 12 hours after sepsis induction (n=6 per group). In the second experiment, rats were sacrificed 7 hours after sepsis induction, and lung tissues and plasma were harvested (n=10 per group).
Results In the survival study, the RW2 group survived longer than the RW1 group (P<0.05), but the RW1 and NT groups showed no significant difference in survival duration (P>0.05). The histological lung injury score and malondialdehyde concentrations in the lung tissues were significantly higher in the RW1 group than in the RW2 group (P<0.05). Plasma interleukin (IL)-6 concentration and the ratio of IL-6 to IL-10 were higher in the RW1 group than in the RW2 group (P<0.05).
Conclusion Rapid rewarming after therapeutic hypothermia results in a shorter survival period and acute lung injury in sepsis, which could be associated with the inflammatory responses.
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Combination Therapy of Niacin and Apocynin Attenuates Lung Injury During Sepsis in Rats Heesu Park, Yoon Sun Jung, Gil Joon Suh, Woon Yong Kwon, Kyung Su Kim, Taegyun Kim, Hayoung Kim, Jieun Shin Journal of Surgical Research.2023; 285: 51. CrossRef
Clinicopathological prognostic indicators of survival and pathological findings in cold-stressed Florida manatees Trichechus manatus latirostris M Martony, JA Hernandez, M de Wit, J St Leger, C Erlacher-Reid, J Vandenberg, NI Stacy Diseases of Aquatic Organisms.2019; 132(2): 85. CrossRef
Is Therapeutic Hypothermia for Acute Respiratory Distress Syndrome the Future? Adam J. Hayek, Heath D. White, Shekhar Ghamande, Christopher Spradley, Alejandro C. Arroliga Journal of Intensive Care Medicine.2017; 32(7): 460. CrossRef
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