title: Targeted temperature management in cardiovascular disease complicated by cardiac arrest.
abstract: OBJECTIVE
  The majority of cardiac arrests occur due to cardiovascular etiology. Targeted temperature management (TTM) (32-34 °C) is a part of the standard post arrest care. We hypothesized that lower body temperature may lead to reduced cardiac metabolic demand and potentially have a beneficial effect on myocardial function.
  
  
  METHODS
  We performed a retrospective study on patients admitted to the intensive care unit following cardiac arrest secondary to cardiovascular etiology over a 9 year period. We assessed the impact of TTM on neurological and cardiac outcomes.
  
  
  RESULTS
  There were 57 patients in the cohort; 21 patients in the TTM group and 36 in the non-TTM group. Demographic characteristics were similar in both groups-the majority of patients (86 vs 80 %, respectively) were males in their 60s. Neurological outcomes were similar; 24 % of patients died during the ICU admission in the TTM group vs 18 % in the non-TTM group. Mean GCS on admission to the ICU was 4 vs 7, respectively, and 11 at discharge in both groups. Majority of patients recovered good neurological function (GCS ≥ 13)-57 % in the TTM group vs 64 % in the non-TTM group. The change in left ventricular function over a 6 month follow up period was significantly better in patients who received targeted temperature management-mean change of +4.4 vs -3.3 %, respectively. This proved to be statistically significant (p = 0.02).
  
  
  CONCLUSIONS
  The study demonstrates a possible beneficial effect of TTM on long-term cardiac function, when instituted following cardiac arrest.
authors.affiliation: Cardiology Department, University College Hospital Galway, Galway, Ireland. miragorecka791@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Gorecka
authors.affiliation: Cardiology Department, University College Hospital Galway, Galway, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Hanley
authors.affiliation: Intensive Care Unit, University College Hospital Galway, Galway, Ireland.
authors.forename: F
authors.initials: F
authors.lastname: Burke
authors.affiliation: Cardiology Department, University College Hospital Galway, Galway, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Nolan
authors.affiliation: Cardiology Department, University College Hospital Galway, Galway, Ireland.
authors.forename: J
authors.initials: J
authors.lastname: Crowley
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000628:therapy*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013696:Temperature
keywords: Cardiac arrest; Cardiovascular disease; Left ventricular ejection fraction; Therapeutic hypothermia