title: Targeted temperature management after intraoperative cardiac arrest: a multicenter retrospective study.
abstract: OBJECTIVE
  Few outcome data are available about temperature management after intraoperative cardiac arrest (IOCA). We describe targeted temperature management (TTM) (32-34 °C) modalities, adverse events, and association with 1-year functional outcome in patients with IOCA.
  
  
  METHODS
  Patients admitted to 11 ICUs after IOCA in 2008-2013 were studied retrospectively. The main outcome measure was 1-year functional outcome.
  
  
  RESULTS
  Of the 101 patients [35 women and 66 men; median age, 62 years (interquartile range, 42-72)], 68 (67.3%) were ASA PS I to III and 57 (56.4%) had emergent surgery. First recorded rhythms were asystole in 44 (43.6%) patients, pulseless electrical activity in 36 (35.6%), and ventricular fibrillation/tachycardia in 20 (19.8%). Median times from collapse to cardiopulmonary resuscitation and return of spontaneous circulation (ROSC) were 0 min (0-0) and 10 min (4-20), respectively. The 30 (29.7%) patients who received TTM had an increased risk of infection (P = 0.005) but not of arrhythmia, bleeding, or metabolic/electrolyte disorders. By multivariate analysis, one or more defibrillation before ROSC was positively associated with a favorable functional outcome at 1-year (OR 3.06, 95% CI 1.05-8.95, P = 0.04) and emergency surgery was negatively associated with 1-year favorable functional outcome (OR 0.36; 95% CI 0.14-0.95, P = 0.038). TTM use was not independently associated with 1-year favorable outcome (OR 0.82; 95% CI 0.27-2.46, P = 0.72).
  
  
  CONCLUSIONS
  TTM was used in less than one-third of patients after IOCA. TTM was associated with infection but not with bleeding or coronary events in this setting. TTM did not independently predict 1-year favorable functional outcome after IOCA in this study.
authors.affiliation: Medical-Surgical Intensive Care Unit, Intensive Care Department, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France.|Department of Anesthesiology and Critical Care Medicine, Hôpital Européen Georges Pompidou, 75015, Paris, France.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Constant
authors.affiliation: Department of Anesthesiology and Surgical Intensive Care Units, Hôpital Henri Mondor, Assistance Publique des Hôpitaux de Paris, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.|Faculté de médecine, Université Paris Est, 8 avenue du général Sarrail, 94000, Créteil, France.|Inserm, U955, Equipe 3 "Stratégies pharmacologiques et thérapeutiques expérimentales des insuffisances cardiaques et coronaires", 8 avenue du général Sarrail, Créteil, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Mongardon
authors.affiliation: SBIM Biostatistics and Medical information, Hôpital Saint-Louis, APHP, 1, avenue Claude Vellefaux, Paris, France.|Université Paris Diderot, Paris, France.|ECSTRA Team (Epidémiologie Clinique et Statistiques pour la Recherche en Santé), UMR 1153 INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Quentin
authors.initials: Q
authors.lastname: Morelot
authors.affiliation: Medical-Surgical Intensive Care Unit, Centre Hospitalier Universitaire de Limoges, 2, avenue Martin-Luther-King, 87042, Limoges, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Pichon
authors.affiliation: Medical-Surgical Intensive Care Unit, Intensive Care Department, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France.
authors.forename: David
authors.initials: D
authors.lastname: Grimaldi
authors.affiliation: Department of Anesthesiology, Institut Gustave Roussy, 39, rue Camille-Desmoulins, 94805, Villejuif Cedex, France.
authors.forename: Lauriane
authors.initials: L
authors.lastname: Bordenave
authors.affiliation: Department of Intensive Care Medicine, Foch Hospital, 40 rue Worth, 92150, Suresnes, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Soummer
authors.affiliation: Pôle Anesthésie-Réanimation-SAMU, CHU de Caen, Avenue de la côte de Nacre, CS30001, 14033, Caen Cedex 9, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Sauneuf
authors.affiliation: Medical-Surgical Intensive Care Unit, Intensive Care Department, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France.
authors.forename: Sybille
authors.initials: S
authors.lastname: Merceron
authors.affiliation: Department of Anesthesiology and Critical Care, Assistance Publique des Hôpitaux de Paris, 100 boulevard du Général-Leclerc, 92110, Clichy la Garenne, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Ricome
authors.affiliation: Medical-Surgical Intensive Care Unit, Groupe Hospitalier Saint Joseph, 185 rue Raymond Losserand, 75614, Paris Cedex, France.|Sorbonne Paris Cité-Medical School, Paris Descartes University, Paris, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Misset
authors.affiliation: Medical-Surgical Intensive Care Unit, Groupe Hospitalier Saint Joseph, 185 rue Raymond Losserand, 75614, Paris Cedex, France.
authors.forename: Cedric
authors.initials: C
authors.lastname: Bruel
authors.affiliation: Medical Intensive Care Unit, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: David
authors.initials: D
authors.lastname: Schnell
authors.affiliation: Medical Intensive Care Unit, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.|EA 7293, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de médecine, Université de Strasbourg, Strasbourg, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Boisramé-Helms
authors.affiliation: Department of Anesthesiology, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Dubuisson
authors.affiliation: Pôle Anesthésie-Réanimation-SAMU, CHU de Caen, Avenue de la côte de Nacre, CS30001, 14033, Caen Cedex 9, France.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Brunet
authors.affiliation: Pôle d'Anesthésie Réanimation, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex 9, Angers, France.|LUNAM Université, CHU d'Angers, 49933, Angers Cedex, France.
authors.forename: Sigismond
authors.initials: S
authors.lastname: Lasocki
authors.affiliation: Intensive Care Unit, Centre Hospitalier Sud-Francilien, 116 boulevard Jean Jaurès, 91106, Corbeil-Essonnes Cedex, France.
authors.forename: Pierrick
authors.initials: P
authors.lastname: Cronier
authors.affiliation: Department of Anesthesiology and Critical Care, Groupe Hospitalier Saint Joseph, 185 rue Raymond Losserand, 75614, Paris Cedex, France.
authors.forename: Belaid
authors.initials: B
authors.lastname: Bouhemad
authors.affiliation: Department of Intensive Care Medicine, Hôpital Saint-Camill, 2 rue des Pères-Camiliens, 94360, Bry-sur-Marne, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Carreira
authors.affiliation: Medical-Surgical Intensive Care Unit, Centre Hospitalier Universitaire de Limoges, 2, avenue Martin-Luther-King, 87042, Limoges, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Begot
authors.affiliation: Department of Anesthesiology, Foch Hospital, 40 rue Worth, 92150, Suresnes, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Vandenbunder
authors.affiliation: Department of Anesthesiology and Surgical Intensive Care Units, Hôpital Henri Mondor, Assistance Publique des Hôpitaux de Paris, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.|Faculté de médecine, Université Paris Est, 8 avenue du général Sarrail, 94000, Créteil, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Dhonneur
authors.affiliation: Department of Anesthesiology, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Jullien
authors.affiliation: SBIM Biostatistics and Medical information, Hôpital Saint-Louis, APHP, 1, avenue Claude Vellefaux, Paris, France.|Université Paris Diderot, Paris, France.|ECSTRA Team (Epidémiologie Clinique et Statistiques pour la Recherche en Santé), UMR 1153 INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Resche-Rigon
authors.affiliation: Medical-Surgical Intensive Care Unit, Intensive Care Department, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bedos
authors.affiliation: SBIM Biostatistics and Medical information, Hôpital Saint-Louis, APHP, 1, avenue Claude Vellefaux, Paris, France.|Université Paris Diderot, Paris, France.|ECSTRA Team (Epidémiologie Clinique et Statistiques pour la Recherche en Santé), UMR 1153 INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Montlahuc
authors.affiliation: Medical-Surgical Intensive Care Unit, Intensive Care Department, Centre Hospitalier de Versailles-Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France. slegriel@ch-versailles.fr.|Sorbonne Paris Cité-Medical School, Paris Descartes University, Paris, France. slegriel@ch-versailles.fr.|INSERM U970, Paris Cardiovascular Research Center, Paris, France. slegriel@ch-versailles.fr.
authors.forename: Stephane
authors.identifier: http://orcid.org/0000-0003-4782-6734
authors.initials: S
authors.lastname: Legriel
mesh_terms: D000328:Adult; D000368:Aged; D001831:Body Temperature; D004554:Electric Countershock; D005260:Female; D005602:France / Q000453:epidemiology; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000379:methods*; D007362:Intensive Care Units; D007431:Intraoperative Complications / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiopulmonary resuscitation; Coma/therapy; Hypothermia; Induced; Intensive care units; Intraoperative complications/therapy