LAUSR

Learning Objectives: A favorable neurological outcome is likely to be achieved by extracorporeal cardiopulmonary resuscitation (ECPR) and follow on targeted temperature management (TTM). However, the optimal temperature during TTM after ECPR is unclear. We analyzed neurological outcomes at two different temperatures of TTM among patients who had undergone ECPR. Methods: In this single center retrospective study, from August 2012 to July 2018, 110 patients underwent TTM for ECPR. Of these, 60 patients had TTM at hypothermia (33°C: Group H), and 25 patients at normothermia (36°C: Group N). 25 patients converted from 33°C to 36°C due to complications were excluded. We compared neurological outcome between two groups. GlasgowPittsburgh Cerebral Performance Category (CPC) 1-2 at 1 month was defined as favorable neurological outcome, CPC3-5 was defined as unfavorable outcome. Results were expressed as Median (IQR). Results: Time intervals from collapse to induction of V-A ECMO were not significantly different between groups (Group H; 40min (35-48) vs Group N; 45min (32-52), P=0.74). 52 % of the patients in Group H (31 of 60 patients) were alive at 1 month, as compared with 56% in Group N (14 of 25 patients) (odds ratio, 0.84; 95% confidence interval [CI], 0.33 to 2.15; P=0.71). At the 1 month follow up, Group H had not a significantly lower rate of favorable neurological outcome than Group N (30% (18/60) vs 48% (12/25), odds ratio, 1.45; 95% CI, 0.79 to 2.47; P=0.13). In longer intervals from collapse to induction of V-A ECMO (≧45min), favorable neurological outcome was not significant different between two groups (Group H:31% (6/19) vs Group N 60% (6/10), p=0.23). Conclusions: Hypothermia at a targeted temperature of 33°C did not confer a benefit as compared with a targeted temperature of 36°C. Hypothermia failed to indicate advantage over normothermia even in the longer down-time, suggesting more severe damage.