Targeted temperature management guided by the severity of hyperlactatemia for out-of-hospital cardiac arrest patients: a post hoc analysis of a nationwide, multicenter prospective registry

Okazaki, Tomoya; Hifumi, Toru; Kawakita, Kenya; Kuroda, Yasuhiro

doi:10.1186/s13613-019-0603-y

Annals of Intensive Care

Table 3 Comparison between 32–34 and 35–36 °C in each hyperlactatemia group

From: Targeted temperature management guided by the severity of hyperlactatemia for out-of-hospital cardiac arrest patients: a post hoc analysis of a nationwide, multicenter prospective registry

Variables	Mild hyperlactatemia		p value	Moderate hyperlactatemia		p value	Severe hyperlactatemia		p value
Variables	32–34 °C n = 108	35–36 °C n = 31	p value	32–34 °C n = 128	35–36 °C n = 54	p value	32–34 °C n = 83	35–36 °C n = 31	p value
Age, years	64 [52, 72]	66 [54, 79]	0.105	62 [50, 74]	71 [51, 80]	0.036	58 [47, 67]	64 [55, 71]	0.112
Age > 65 years	47 (43.5)	16 (51.6)	0.540	50 (39)	31 (57)	0.033	24 (28.9)	14 (45.2)	0.121
Male sex	80 (74)	25 (81)	0.636	101 (79)	42 (78)	0.846	67 (81)	23 (74)	0.449
Witness	92 (85)	26 (84)	0.784	106 (83)	43 (80)	0.675	61 (74)	20 (65)	0.361
Dispatcher instruction	48 (44)	18 (58)	0.222	63 (49)	26 (48)	1.000	31 (37)	12 (39)	1.000
Bystander-performed CPR	58 (54)	19 (61)	0.540	73 (57)	27 (50)	0.417	39 (47)	12 (39)	0.527
Cardiac etiology	90 (83)	25 (81)	0.788	98 (77)	37 (69)	0.271	61 (74)	21 (68)	0.640
Initial shockable rhythm	74 (69)	14 (45)	0.021	75 (59)	25 (46)	0.144	36 (43)	11 (36)	0.524
Prehospital epinephrine administration	18 (17)	3 (10)	0.409	31 (24)	10 (19)	0.444	27 (33)	10 (32)	1.000
Prehospital advanced airway management	24 (22)	9 (29)	0.475	41 (32)	20 (37)	0.606	37 (45)	14 (45)	1.000
Prehospital AED	90 (83)	24 (77)	0.437	93 (73)	39 (72)	1.000	50 (60)	17 (55)	0.671
Response time, min	8 [6, 9]	8 [6, 10]	0.749	7 [6, 9]	8 [6, 9]	0.381	8 [6, 9]	8 [7, 11]	0.329
Time from call to hospital arrival, min	32 [25, 40]	31 [23, 33]	0.283	30 [24, 34]	31 [24, 36]	0.542	29 [25, 37]	28 [24, 39]	0.769
Prehospital ROSC	77 (71)	25 (81)	0.362	78 (61)	34 (63)	0.868	31 (37)	7 (23)	0.181
Glasgow Coma Scale score	3 [3, 3]	3 [3, 6]	0.097	3 [3, 3]	3 [3, 3]	0.602	3 [3, 3]	3 [3, 3]	0.856
Coronary angiography	66 (61)	19 (61)	1.000	78 (61)	28 (52)	0.324	52 (63)	14 (45)	0.135
ECMO and/or IABP	37 (34.3)	8 (25.8)	0.514	50 (39)	13 (24)	0.061	32 (39)	9 (29)	0.388
Door-to-first ABG measurement after ROSC, min	11 [5, 32]	9 [5, 22]	0.300	10 [5, 17]	9 [6, 18]	0.784	13 [6, 30]	19 [11, 35]	0.056
pH	7.28 [7.22, 7.32]	7.31 [7.20, 7.37]	0.107	7.14 [7.02, 7.28]	7.08 [7.01, 7.25]	0.356	6.92 [6.81, 7.03]	6.91 [6.74, 7.15]	0.817
PaCO₂, mm Hg	43 [38, 51]	40 [33, 51]	0.318	47 [34, 75]	60 [36, 75]	0.200	69 [44, 90]	72 [31, 108]	0.873
PaCO₂ 30–50 mm Hg	71 (65.7)	19 (61.3)	0.674	50 (39)	13 (24)	0.061	23 (28)	4 (13)	0.137
PaO₂, mm Hg	170 [91, 350]	176 [93, 325]	0.975	179 [86, 354]	195 [113, 350]	0.449	148 [76, 345]	240 [86, 363]	0.437
HCO₃, mmol/l	20.0 [16.8, 21.5]	19.9 [18.0, 22.8]	0.608	16.3 [13.9, 18.5]	16.6 [13.6, 19.5]	0.471	13.0 [10.4, 17.1]	12.7 [10.3, 15.1]	0.530
Base excess, mmol/l	− 6.4 [− 9.3, − 4.0]	− 5.7 [− 7.3, − 4.1]	0.369	− 11.9 [− 14.9, − 9.4]	− 12.5 [− 14.0, − 9.9]	0.905	− 19.6 [− 23.7, − 16.2]	− 19.4 [− 24.5, − 12.6]	0.703
Lactate value, mmol/l	5.1 [3.6, 6, 1]	5.4 [3.9, 6.5]	0.185	9.1 [7.9, 10.1]	9.3 [8.1, 10.6]	0.775	14.7 [13.1, 17.3]	16.2 [14.0, 19.4]	0.113
Door-to-TTM initiation, min	82 [20, 174]	167 [109, 213]	0.003	78 [21, 170]	164 [103., 218]	< 0.001	105 [35, 202]	198 [109, 261]	0.002
30-day favorable neurological outcome	65 (60)	19 (61)	1.000	56 (44)	20 (37)	0.417	18 (22)	4 (13)	0.425
30-day survival	89 (82)	28 (90)	0.406	100 (78)	44 (82)	0.693	48 (58)	16 (52)	0.672

Continuous variables were presented as median [Interquartile range]. Categorical variables were presented as n (%)
CPR cardiopulmonary resuscitation, AED automated external defibrillator, ROSC return of spontaneous circulation, ECMO extracorporeal membrane oxygenation, IABP intra-aortic balloon pumping, ABG arterial blood gas

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