Duration of Device-Based Fever Prevention after Cardiac Arrest | NEJM - nejm.org

Abstract

Background

Guidelines urge progressive fever prevention for 72 hours aft cardiac arrest. Data from randomized objective trials of this involution person been lacking.

Methods

We randomly assigned comatose patients who had been resuscitated aft an out-of-hospital cardiac apprehension of presumed cardiac origin to device-based somesthesia power targeting 36°C for 24 hours followed by targeting of 37°C for either 12 oregon 48 hours (for full involution times of 36 and 72 hours, respectively) oregon until the diligent regained consciousness. The superior result was a composite of decease from immoderate origin oregon infirmary discharge with a Cerebral Performance Category of 3 oregon 4 (range, 1 to 5, with higher scores indicating much terrible disability; a class of 3 oregon 4 indicates terrible cerebral disablement oregon coma) wrong 90 days aft randomization. Secondary outcomes included decease from immoderate origin and the Montreal Cognitive Assessment people (range, 0 to 30, with higher scores indicating amended cognitive ability) astatine 3 months.

Results

A full of 393 patients were randomly assigned to somesthesia power for 36 hours, and 396 patients were assigned to somesthesia power for 72 hours. At 90 days aft randomization, a superior end-point lawsuit had occurred successful 127 of 393 patients (32.3%) successful the 36-hour radical and successful 133 of 396 patients (33.6%) successful the 72-hour radical (hazard ratio, 0.99; 95% assurance interval, 0.77 to 1.26; P=0.70) and mortality was 29.5% successful the 36-hour radical and 30.3% successful the 72-hour group. At 3 months, the median Montreal Cognitive Assessment people was 26 (interquartile range, 24 to 29) and 27 (interquartile range, 24 to 28), respectively. There was nary important between-group quality successful the incidence of adverse events.

Conclusions

Active device-based fever prevention for 36 oregon 72 hours aft cardiac apprehension did not effect successful importantly antithetic percentages of patients dying oregon having terrible disablement oregon coma. (Funded by the Novo Nordisk Foundation; BOX ClinicalTrials.gov number, NCT03141099.)