title: Effectiveness of lower target temperature therapeutic hypothermia in post-cardiac arrest syndrome patients with a resuscitation interval of ≤30 min.
abstract: BACKGROUND
  Therapeutic hypothermia (TH) is a standard strategy to reduce brain damage in post-cardiac arrest syndrome (PCAS) patients. However, it is unknown whether the target temperature should be adjusted for PCAS patients in different states.
  
  
  METHODS
  Participants in the J-PULSE-Hypo study database were divided into lower (32.0-33.5 °C; Group L) or moderate (34.0-35.0 °C; Group M) temperature groups. Primary outcome was a favourable neurological outcome (proportion of patients with a Glasgow-Pittsburgh Cerebral Performance Category [CPC] of 1-2 on day 30). We compared between the two groups and in subgroups of patients divided by age and resuscitation interval (interval from collapse to return of spontaneous circulation) by propensity score (PS) analysis.
  
  
  RESULTS
  Overall, 467 participants were analysed. The proportions of patients with favourable neurological outcomes were as follows (Group L vs. Group M) (OR; Odds ratio): all patients, 64 % (n = 42) vs. 55 % ((n = 424) (PS; OR 1.381 (0.596-3.197)), P = 0.452) and resuscitation interval ≤ 30 min, 88 % (n = 24) vs. 64 % ((n = 281) (PS; OR 7.438 (1.769-31.272)), P = 0.007).
  
  
  CONCLUSIONS
  PCAS patients with a resuscitation interval of <30 min may be candidates for TH with a target temperature of <34 °C.
  
  
  BACKGROUND
  University Hospital Medical Information Network (UMIN) Clinical Trials Registry UMIN000001935; available at: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000002348&language=J.
authors.affiliation: Emergency and General Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556 Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kaneko
authors.affiliation: Emergency and General Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556 Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Kasaoka
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Ube, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakahara
authors.affiliation: Senri Critical Care Medical Center, Saiseikai Senri Hospital, Osaka, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Sawano
authors.affiliation: Division of Cardiovascular Care Unit, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tahara
authors.affiliation: Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Hase
authors.affiliation: Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Nishioka
authors.affiliation: Division of Cardiology, Kokura Memorial Hospital, Kokura, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Shirai
authors.affiliation: Emergency Medicine, Osaka Mishima Emergency and Critical Care Center, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hazui
authors.affiliation: Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Arimoto
authors.affiliation: Cardiovascular Division, Osaka Police Hospital, Osaka, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kashiwase
authors.affiliation: Department of Emergency and Critical Care Medicine, Chiba Hokusoh Hospital, Nippon Medical School, Inzai, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Motomura
authors.affiliation: Emergency and Critical Care Center, Kagawa University Hospital, Kagawa, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kuroda
authors.affiliation: Department of Cardiology, Sumitomo Hospital, Osaka, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yasuga
authors.affiliation: Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Yonemoto
authors.affiliation: Division of Cardiovascular Care Unit, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yokoyama
authors.affiliation: Department of Cardiology, Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital, Tokyo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Nagao
authors.affiliation: Shizuoka General Hospital, Shizuoka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nonogi
keywords: Post-cardiac arrest syndrome; Prolonged hypothermia; Rapid cooling; Slow rewarming; Target temperature