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Article

Risks According to the Timing and Frequency of Hypotension Episodes in Postanoxic Comatose Patients

by 1, 2,*, 3, 4, 5 and 4 on behalf of the Korean Hypothermia Network Investigators
1
Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Gyeongsangnam-do 51353, Korea
2
Department of Emergency Medicine, Dong-A University College of Medicine, Busan 49201, Korea
3
Division of Convergence Education, Halla University, Wonju 26404, Korea
4
Department of Emergency Medicine, Chonnam National University Medical School, Gwangju 35015, Korea
5
Department of Emergency Medicine, Ulsan University College of Medicine, Seoul 44033, Korea
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(9), 2750; https://doi.org/10.3390/jcm9092750
Received: 7 August 2020 / Revised: 20 August 2020 / Accepted: 24 August 2020 / Published: 25 August 2020
The aim of this study was to assess the risk of unfavorable outcomes according to the timing of hypotension episodes in cardiac arrest patients. This prospectively conducted multicenter observational study included 1373 out-of-hospital cardiac arrest patients treated with 33 °C targeted temperature management (TTM). Unfavorable neurological outcome and the incidence of complications were analyzed according to the timing of hypotension. Compared with hypotension before TTM initiation (adjusted hazard ratio (aHR) 1.51), hypotension within 6 h after TTM initiation was associated with an increased risk of unfavorable neurologic outcome (aHR 1.693), and after 24 h of TTM, was connected with decreased risk (aHR 1.277). The risk of unfavorable neurological outcome was gradually reduced over time after TTM initiation. Hypotension, persisting both before and during TTM, demonstrated a greater risk (aHR 2) than transient hypotension (aHR 1.265). Hypotension was correlated with various complications. Differences in lactate levels were persistent, regardless of the initial fluid therapy (p < 0.001). Hypotension showed a strong correlation with unfavorable neurological outcome, especially in the early phase after TTM initiation, and complications. It is essential to manage hypotension that occurs at the beginning of TTM initiation to recover cerebral function in cardiac arrest patients. View Full-Text
Keywords: out-of-hospital cardiac arrest; hypothermia; induced; hypotension; shock; hemodynamics out-of-hospital cardiac arrest; hypothermia; induced; hypotension; shock; hemodynamics
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MDPI and ACS Style

Kim, Y.H.; Lee, J.H.; Seo, J.I.; Lee, D.H.; Kim, W.Y.; Lee, B.K., on behalf of the Korean Hypothermia Network Investigators. Risks According to the Timing and Frequency of Hypotension Episodes in Postanoxic Comatose Patients. J. Clin. Med. 2020, 9, 2750. https://doi.org/10.3390/jcm9092750

AMA Style

Kim YH, Lee JH, Seo JI, Lee DH, Kim WY, Lee BK on behalf of the Korean Hypothermia Network Investigators. Risks According to the Timing and Frequency of Hypotension Episodes in Postanoxic Comatose Patients. Journal of Clinical Medicine. 2020; 9(9):2750. https://doi.org/10.3390/jcm9092750

Chicago/Turabian Style

Kim, Yong H., Jae H. Lee, Jung I. Seo, Dong H. Lee, Won Y. Kim, and Byung K. Lee on behalf of the Korean Hypothermia Network Investigators 2020. "Risks According to the Timing and Frequency of Hypotension Episodes in Postanoxic Comatose Patients" Journal of Clinical Medicine 9, no. 9: 2750. https://doi.org/10.3390/jcm9092750

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