Quality of life was good and cognitive function was similar in patients with cardiac arrest who received targeted body-temperature management as a neuroprotective measure in intensive care units in Europe and Australia, according to an article published online by JAMA Neurology.
Brain injury is the primary cause of death for patients treated in intensive care units after suffering cardiac arrest (CA) outside of a hospital. Targeted temperature management (TTM) has been implemented as a neuroprotective treatment for comatose CA survivors because of reports of improved survival, according to background information in the study.
Niklas Nielsen, M.D., Ph.D., of Lund University and Helsingborg Hospital, Sweden, and coauthors compared the effect of two targeted temperature regimens on long-term cognitive function and quality of life after CA. The clinical trial was performed from November 2010 through part of January 2013 and it included 939 adults, who were unconscious with CA, in its final analysis.
Patients were assigned to either temperature management at 33 degrees Celsius (91.4 degrees Fahrenheit) or 36 degrees Celsius (96.8 degrees Fahrenheit). The intervention lasted 36 hours and patients were cooled down or warm up to the assigned temperature, according to the study. Patient cognitive function and quality of life were measured six months after the CA.
At follow-up, 245 patients were alive in the 33-degree-Celsius group and 246 were alive in the 36-degree-Celsius group. The study found scores of cognitive function were similar for both temperature groups. There was no difference in the percentage of patients with an increased need for help in activities of daily living, with 46 (18.8 percent) in the 33-degree-Celsius group and 43 (17.5 percent) in the 36-degree-Celsius group. Also, 66.5 percent of patients in the 33-degree-Celsius group and 61.8 percent in the 36-degree-Celsius group reported they thought they had made a complete mental recovery.
"Quality of life was good and similar in patients with CA receiving TTM at 33 degrees Celsius or 36 degrees Celsius. Cognitive function was similar in both intervention groups, but many patients and observers reported impairment not detected previously by standard outcome scales," the study concludes.
In a related editorial, Venkatesh Aiyagari, M.B.B.S., D.M., of the University of Texas Southwestern Medical Center, Dallas, and Michael N. Diringer, M.D., of the Washington University School of Medicine, St. Louis, write: "For neurologists who are often called on to render an opinion on the prognosis of unconscious patients after CA, an important take-home message from this study is that although cognitive changes are common, the overall long-term outcome of patients with a CA who survive to hospital discharge is quite good. Most of these patients are discharged home and report no problem with self-care and a significant number are gainfully employed. Similar findings have also been reported in a study of 927 CA survivors in Victoria, Australia, and reinforce the view that patients who survive a CA and are unconscious should be managed with intensive support measures, including TTM, and premature prognostication should be avoided."
Explore further: Cochlear implantation improved speech perception, cognitive function in older adults
More information: JAMA Neurol. Published online April 6, 2015. DOI: 10.1001/jamaneurol.2015.0169
JAMA Neurol. Published online April 6, 2015. DOI: 10.1001/jamaneurol.2015.0164
Medical Xpress on facebook
Related Stories
Study finds no difference in survival when lowering cardiac arrest patients' temperature to 33°C vs. 36°C
Lowering cardiac arrest patients' body temperatures to 33°C (91.4°F) instead of 36°C (96.8°F) did not improve survival or neurological/cognitive function in a late-breaking clinical trial presented at the American Heart ...
Study questions hypothermia treatment for cardiac arrest
Therapeutic hypothermia – cooling the body and brain down to 33°C – is the method used worldwide to treat cardiac arrest, even though a lower body temperature may raise the risk of side-effects. However, keeping the ...
Effect of lowering of body temperature for adults with cardiac arrest prior to hospital arrival
Francis Kim, M.D., of Harborview Medical Center, Seattle, and colleagues evaluated whether early prehospital cooling (lowering body temperature) improved survival to hospital discharge and neurological outcome in cardiac ...
Cochlear implantation improved speech perception, cognitive function in older adults
Cochlear implantation was associated with improved speech perception and cognitive function in adults 65 years or older with profound hearing loss, according to a report published online by JAMA Otolaryngology-Head & Neck Su ...
Cold effects on skin in raynaud's impacted by age, BMI
(HealthDay)—For patients with Raynaud's phenomenon (RP), cold-induced decrease in skin temperature is related to age and body mass index (BMI), according to a study published in the January issue of Arthritis & ...
Recommended for you
Toward a model of synchrony in brain networks
(MedicalXpress)—Resting state networks (RSNs) in the brain are topographies of neural structures between which lag states propagate due to fluctuations of physical and other activities. Studying these networks ...
Deconstructing brain systems involved in memory and spatial skills
In work that reconciles two competing views of brain structures involved in memory and spatial perception, researchers at University of California, San Diego School of Medicine have conducted experiments ...
Researchers create artificial link between unrelated memories
The ability to learn associations between events is critical for survival, but it has not been clear how different pieces of information stored in memory may be linked together by populations of neurons. ...
Visual objects are represented by a distributed network in the human brain
LSU Psychology Professor Megan H. Papesh was part of a research team whose study appeared in the online-first edition of the Journal of Neuroscience on Wednesday, April 1. The research, jointly conducted by sci ...
Scientists make major breakthrough in understanding the 'unnoticed' senses
Researchers at the University of Aberdeen have taken a step closer to understanding the nerve endings which report touch and movement to the brain - which could potentially be a powerful new drug target and ...
Learning disabilities commonly found in Wiedemann-Steiner Syndrome can now be investigated in the lab
Wiedemann-Steiner Syndrome is a rare genetic disease. Patients typically suffer from several handicaps and physical symptoms and often struggle with cognitive deficits from childhood on. One gene (MLL1) has ...
User comments
Please sign in to add a comment. Registration is free, and takes less than a minute. Read more
Click here to reset your password.
Sign in to get notified via email when new comments are made.
Quality of life was good and cognitive function was similar in patients with cardiac arrest who received targeted body-temperature management as a neuroprotective measure in intensive care units in Europe and Australia, according to an article published online by JAMA Neurology.
Brain injury is the primary cause of death for patients treated in intensive care units after suffering cardiac arrest (CA) outside of a hospital. Targeted temperature management (TTM) has been implemented as a neuroprotective treatment for comatose CA survivors because of reports of improved survival, according to background information in the study.
Niklas Nielsen, M.D., Ph.D., of Lund University and Helsingborg Hospital, Sweden, and coauthors compared the effect of two targeted temperature regimens on long-term cognitive function and quality of life after CA. The clinical trial was performed from November 2010 through part of January 2013 and it included 939 adults, who were unconscious with CA, in its final analysis.
Patients were assigned to either temperature management at 33 degrees Celsius (91.4 degrees Fahrenheit) or 36 degrees Celsius (96.8 degrees Fahrenheit). The intervention lasted 36 hours and patients were cooled down or warm up to the assigned temperature, according to the study. Patient cognitive function and quality of life were measured six months after the CA.
At follow-up, 245 patients were alive in the 33-degree-Celsius group and 246 were alive in the 36-degree-Celsius group. The study found scores of cognitive function were similar for both temperature groups. There was no difference in the percentage of patients with an increased need for help in activities of daily living, with 46 (18.8 percent) in the 33-degree-Celsius group and 43 (17.5 percent) in the 36-degree-Celsius group. Also, 66.5 percent of patients in the 33-degree-Celsius group and 61.8 percent in the 36-degree-Celsius group reported they thought they had made a complete mental recovery.
"Quality of life was good and similar in patients with CA receiving TTM at 33 degrees Celsius or 36 degrees Celsius. Cognitive function was similar in both intervention groups, but many patients and observers reported impairment not detected previously by standard outcome scales," the study concludes.
In a related editorial, Venkatesh Aiyagari, M.B.B.S., D.M., of the University of Texas Southwestern Medical Center, Dallas, and Michael N. Diringer, M.D., of the Washington University School of Medicine, St. Louis, write: "For neurologists who are often called on to render an opinion on the prognosis of unconscious patients after CA, an important take-home message from this study is that although cognitive changes are common, the overall long-term outcome of patients with a CA who survive to hospital discharge is quite good. Most of these patients are discharged home and report no problem with self-care and a significant number are gainfully employed. Similar findings have also been reported in a study of 927 CA survivors in Victoria, Australia, and reinforce the view that patients who survive a CA and are unconscious should be managed with intensive support measures, including TTM, and premature prognostication should be avoided."
Explore further: Cochlear implantation improved speech perception, cognitive function in older adults
More information: JAMA Neurol. Published online April 6, 2015. DOI: 10.1001/jamaneurol.2015.0169
JAMA Neurol. Published online April 6, 2015. DOI: 10.1001/jamaneurol.2015.0164
Medical Xpress on facebook
Related Stories
Study finds no difference in survival when lowering cardiac arrest patients' temperature to 33°C vs. 36°C
Lowering cardiac arrest patients' body temperatures to 33°C (91.4°F) instead of 36°C (96.8°F) did not improve survival or neurological/cognitive function in a late-breaking clinical trial presented at the American Heart ...
Study questions hypothermia treatment for cardiac arrest
Therapeutic hypothermia – cooling the body and brain down to 33°C – is the method used worldwide to treat cardiac arrest, even though a lower body temperature may raise the risk of side-effects. However, keeping the ...
Effect of lowering of body temperature for adults with cardiac arrest prior to hospital arrival
Francis Kim, M.D., of Harborview Medical Center, Seattle, and colleagues evaluated whether early prehospital cooling (lowering body temperature) improved survival to hospital discharge and neurological outcome in cardiac ...
Cochlear implantation improved speech perception, cognitive function in older adults
Cochlear implantation was associated with improved speech perception and cognitive function in adults 65 years or older with profound hearing loss, according to a report published online by JAMA Otolaryngology-Head & Neck Su ...
Cold effects on skin in raynaud's impacted by age, BMI
(HealthDay)—For patients with Raynaud's phenomenon (RP), cold-induced decrease in skin temperature is related to age and body mass index (BMI), according to a study published in the January issue of Arthritis & ...
Recommended for you
Toward a model of synchrony in brain networks
(MedicalXpress)—Resting state networks (RSNs) in the brain are topographies of neural structures between which lag states propagate due to fluctuations of physical and other activities. Studying these networks ...
Deconstructing brain systems involved in memory and spatial skills
In work that reconciles two competing views of brain structures involved in memory and spatial perception, researchers at University of California, San Diego School of Medicine have conducted experiments ...
Researchers create artificial link between unrelated memories
The ability to learn associations between events is critical for survival, but it has not been clear how different pieces of information stored in memory may be linked together by populations of neurons. ...
Visual objects are represented by a distributed network in the human brain
LSU Psychology Professor Megan H. Papesh was part of a research team whose study appeared in the online-first edition of the Journal of Neuroscience on Wednesday, April 1. The research, jointly conducted by sci ...
Scientists make major breakthrough in understanding the 'unnoticed' senses
Researchers at the University of Aberdeen have taken a step closer to understanding the nerve endings which report touch and movement to the brain - which could potentially be a powerful new drug target and ...
Learning disabilities commonly found in Wiedemann-Steiner Syndrome can now be investigated in the lab
Wiedemann-Steiner Syndrome is a rare genetic disease. Patients typically suffer from several handicaps and physical symptoms and often struggle with cognitive deficits from childhood on. One gene (MLL1) has ...
User comments
Please sign in to add a comment. Registration is free, and takes less than a minute. Read more
Click here
to reset your password.
Sign in to get notified via email when new comments are made.
0 comments:
Post a Comment