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Holm A, Kirkegaard H, Taccone FS, et al. Factors Associated With Rebound Hyperthermia After Targeted Temperature Management in Out-of-Hospital Cardiac Arrest Patients: An Explorative Substudy of the Time-Differentiated Therapeutic Hypothermia in Out-of-Hospital Cardiac Arrest Survivors Trial. Crit Care Explor. 2021;3(7):e0458doi: 10.1097/CCE.0000000000000458.
Holm, A., Kirkegaard, H., Taccone, F. S., Søreide, E., Grejs, A. M., Toome, V., Hassager, C., Rasmussen, B. S., Laitio, T., Storm, C., Hästbacka, J., & Skrifvars, M. B. (2021). Factors Associated With Rebound Hyperthermia After Targeted Temperature Management in Out-of-Hospital Cardiac Arrest Patients: An Explorative Substudy of the Time-Differentiated Therapeutic Hypothermia in Out-of-Hospital Cardiac Arrest Survivors Trial. Critical care explorations, 3(7), e0458. https://doi.org/10.1097/CCE.0000000000000458
Holm, Aki, et al. "Factors Associated With Rebound Hyperthermia After Targeted Temperature Management in Out-of-Hospital Cardiac Arrest Patients: An Explorative Substudy of the Time-Differentiated Therapeutic Hypothermia in Out-of-Hospital Cardiac Arrest Survivors Trial." Critical care explorations vol. 3,7 (2021): e0458. doi: https://doi.org/10.1097/CCE.0000000000000458
Holm A, Kirkegaard H, Taccone FS, Søreide E, Grejs AM, Toome V, Hassager C, Rasmussen BS, Laitio T, Storm C, Hästbacka J, Skrifvars MB. Factors Associated With Rebound Hyperthermia After Targeted Temperature Management in Out-of-Hospital Cardiac Arrest Patients: An Explorative Substudy of the Time-Differentiated Therapeutic Hypothermia in Out-of-Hospital Cardiac Arrest Survivors Trial. Crit Care Explor. 2021 Jul 06;3(7):e0458. doi: 10.1097/CCE.0000000000000458. eCollection 2021 Jul. PMID: 34250498; PMCID: PMC8263323.
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Crit Care Explor. 2021 Jul 06;3(7):e0458. doi: 10.1097/CCE.0000000000000458. eCollection 2021 Jul.

Factors Associated With Rebound Hyperthermia After Targeted Temperature Management in Out-of-Hospital Cardiac Arrest Patients: An Explorative Substudy of the Time-Differentiated Therapeutic Hypothermia in Out-of-Hospital Cardiac Arrest Survivors Trial.

Critical care explorations

Aki Holm, Hans Kirkegaard, Fabio Silvio Taccone, Eldar Søreide, Anders M Grejs, Valdo Toome, Christian Hassager, Bodil S Rasmussen, Timo Laitio, Christian Storm, Johanna Hästbacka, Markus B Skrifvars

Affiliations

  1. Department of Emergency Care and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  2. Research Center for Emergency Medicine, Department of Emergency Medicine and Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark.
  3. Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
  4. Critical Care and Anaesthesiology Research Group, Department of Anesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway.
  5. Department Clinical Medicine, University of Bergen, Bergen, Norway.
  6. Department of Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark.
  7. Department of Intensive Cardiac Care, North Estonia Medical Centre, Tallinn, Estonia.
  8. Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
  9. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  10. Department of Anesthesiology and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark.
  11. Department of Clinical Institute, Aalborg University, Aalborg, Denmark.
  12. Division of Perioperative Services, Department of Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland.
  13. Department of Internal Medicine, Nephrology and Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany.
  14. Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

PMID: 34250498 PMCID: PMC8263323 DOI: 10.1097/CCE.0000000000000458

Abstract

To investigate rebound hyperthermia following targeted temperature management after cardiac arrest and its impact on functional outcome.

DESIGN: Post hoc analysis.

SETTING: Ten European ICUs.

PATIENTS: Patients included in the time-differentiated therapeutic hypothermia in out-of-hospital cardiac arrest survivors trial treated with targeted temperature management at 33°C for 48 or 24 hours. Favorable functional outcome was defined as a Cerebral Performance Category of 1 or 2 at 6 months.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Of 338 included patients, 103 (30%) experienced rebound hyperthermia defined as a maximum temperature after targeted temperature management and rewarming exceeding 38.5°C. Using multivariate logistic regression analysis, increasing age (odds ratio, 0.97; 95% CI, 0.95-0.99;

CONCLUSIONS: One-third of targeted temperature management patients experience rebound hyperthermia, and it is more common in younger male patients with an aggravated inflammatory response and those treated with a mechanical chest compression device. Later onset of rebound hyperthermia and temperatures exceeding 38.5°C associate with unfavorable outcome.

Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.

Keywords: fever; out-of-hospital cardiac arrest; rebound hyperthermia; resuscitation; targeted temperature management

Conflict of interest statement

Dr. Taccone received lecture fees from BD and ZOLL. Dr. Storm reports having received travel reimbursements and speaker fees from BD BARD and Zoll GmbH, as well as honorarium for consultancy from BD B

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