Evidence map›Paper›PMID 36380332›Full record

Trial reportCritical care (London, England)2022

Speed of cooling after cardiac arrest in relation to the intervention effect: a sub-study from the TTM2-trial.

Rupert F G Simpson, Josef Dankiewicz, Grigoris V Karamasis, Paolo Pelosi, Matthias Haenggi, Paul J Young, Janus Christian Jakobsen, Jonathan Bannard-Smith, Pedro D Wendel-Garcia, Fabio Silvio Taccone and 14 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Rupert F G SimpsonEssex Cardiothoracic Centre, MSE Trust, Basildon, Essex, UK.
Josef DankiewiczDepartment of Clinical Sciences Lund, Sections of Cardiology, Lund, Sweden.
Grigoris V KaramasisEssex Cardiothoracic Centre, MSE Trust, Basildon, Essex, UK.
Paolo PelosiDepartment of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.
Matthias HaenggiDepartment of Intensive Care Medicine, University Hospital Bern, University of Bern, Bern, Switzerland.
Paul J YoungIntensive Care Unit, Wellington Hospital, Wellington, New Zealand.
Janus Christian JakobsenCopenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen, Capital Region of Denmark, Denmark.
Jonathan Bannard-SmithDepartment of Adult Critical Care, Manchester University NHS Foundation Trust, Manchester, UK.
Pedro D Wendel-GarciaInstitute of Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland.
Fabio Silvio TacconeDepartment of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
Per NordbergDepartment of Clinical Science and Education, Center for Resuscitation Science, Karolinska Institute, Solna, Sweden.
Matt P WiseAdult Critical Care, University Hospital of Wales, Cardiff, UK.
Anders M GrejsDepartment of Intensive Care Medicine, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
Gisela LiljaNeurology, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden.
Roy Bjørkholt OlsenDepartment of Anesthesiology, Sørlandet Hospital, Arendal, Norway.
Alain CariouMedical Intensive Care Unit, Cochin University Hospital (APHP), Paris Cité University, Paris, France.
Jean Baptiste LascarrouMedicine Intensive Reanimation, CHU Nantes, Nantes, France.
Manoj SaxenaCritical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia.
Jan HovdenesDivision of Emergencies and Critical Care, Department of Anesthesiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Matthew ThomasIntensive Care Unit, University Hospitals Bristol and Weston, Bristol, UK.
Hans FribergDepartment of Clinical Science, Intensive and Perioperative Care, Skane University Hospital, Lund University, Malmo, Sweden.
John R DaviesEssex Cardiothoracic Centre, MSE Trust, Basildon, Essex, UK.
Niklas NielsenDepartment of Clinical Sciences Lund, Sections of Anesthesiology and Intensive Care, Lund, Sweden.
Thomas R KeebleEssex Cardiothoracic Centre, MSE Trust, Basildon, Essex, UK. thomas.keeble2@nhs.net.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTargeted temperature management (TTM) is recommended following cardiac arrest; however, time to target temperature varies in clinical practice. We hypothesised the effects of a target temperature of 33 °C when compared to normothermia would differ based on average time to hypothermia and those patients achieving hypothermia fastest would have more favorable outcomes.

methodsIn this post-hoc analysis of the TTM-2 trial, patients after out of hospital cardiac arrest were randomized to targeted hypothermia (33 °C), followed by controlled re-warming, or normothermia with early treatment of fever (body temperature, ≥ 37.8 °C). The average temperature at 4 h (240 min) after return of spontaneous circulation (ROSC) was calculated for participating sites. Primary outcome was death from any cause at 6 months. Secondary outcome was poor functional outcome at 6 months (score of 4-6 on modified Rankin scale).

resultsA total of 1592 participants were evaluated for the primary outcome. We found no evidence of heterogeneity of intervention effect based on the average time to target temperature on mortality (p = 0.17). Of patients allocated to hypothermia at the fastest sites, 71 of 145 (49%) had died compared to 68 of 148 (46%) of the normothermia group (relative risk with hypothermia, 1.07; 95% confidence interval 0.84-1.36). Poor functional outcome was reported in 74/144 (51%) patients in the hypothermia group, and 75/147 (51%) patients in the normothermia group (relative risk with hypothermia 1.01 (95% CI 0.80-1.26).

conclusionsUsing a hospital's average time to hypothermia did not significantly alter the effect of TTM of 33 °C compared to normothermia and early treatment of fever.

Indexed as

Cardiopulmonary ResuscitationHypothermiaHypothermia, InducedOut-of-Hospital Cardiac ArrestCold TemperatureFeverHumansTreatment OutcomeHypothermiaOut of hospital cardiac arrestTemperature managementTime to target temperature

Identifiers

PMID36380332
PMCPMC9667681

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.