Background

Various methods have been used to control body temperature in targeted temperature management (TTM), but few studies have compared specific subtypes of surface cooling systems. The aim of this study was to compare the efficiencies and neurological outcomes between hydrogels pad and water-circulating blanket cooling methods.

Methods

We conducted a multicentre, prospective, registry-based study of out-of-hospital cardiac arrest patients treated with TTM between 2015 and 2018. We compared the neurological outcomes, efficacies for cooling, and adverse events between patients who received TTM using a hydrogel pad and water-circulating blanket cooling. Patients were one-to-one matched using propensity scores to adjust for differences in the baseline characteristics of each cooling method. The primary outcome was a favourable neurological outcome at 6 months.

Results

We included 1,132 patients in the analysis, 870 of whom underwent hydrogel pad cooling, and the remaining 262 underwent water-circulating blanket cooling. In the unmatched cohort, a greater number of adverse events occurred in the water-circulating blanket group. The favourable neurologic outcome rates at 6 months were similar between the hydrogel pad group and the water circulating blanket group (30.2% vs. 29.8%, p = 0.939). In the propensity-matched cohort, which included 184 pairs, the rates of adverse events between the two groups were similar. The similarity of favourable neurologic outcome rates at 6 months between the two groups persisted (28.8% vs. 29.9%, p = 0.819).

Conclusion

Neurological outcomes and adverse events between the hydrogel pad cooling and water-circulating blanket cooling groups were similar.

中文翻译：

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用于目标温度管理的水凝胶垫和水循环毯冷却方法的比较：来自前瞻性多中心注册的倾向评分匹配分析

背景

在目标温度管理 (TTM) 中已使用各种方法来控制体温，但很少有研究比较表面冷却系统的特定亚型。本研究的目的是比较水凝胶垫和水循环毯冷却方法之间的效率和神经学结果。

方法

我们对 2015 年至 2018 年间接受 TTM 治疗的院外心脏骤停患者进行了一项多中心、前瞻性、基于注册的研究。我们比较了使用水凝胶垫接受 TTM 治疗的患者之间的神经学结局、降温效果和不良事件和水循环毯冷却。使用倾向评分对患者进行一对一匹配，以调整每种冷却方法的基线特征差异。主要结果是 6 个月时良好的神经学结果。

结果

我们在分析中纳入了 1,132 名患者，其中 870 名接受了水凝胶垫冷却，其余 262 名接受了水循环毯冷却。在不匹配的队列中，水循环毯组发生了更多的不良事件。6 个月时，水凝胶垫组和水循环毯组的良好神经系统结果率相似（30.2% 对 29.8%，p =  0.939）。在包括 184 对的倾向匹配队列中，两组之间的不良事件发生率相似。两组之间 6 个月时良好神经系统结果率的相似性持续存在（28.8% 对 29.9%，p =  0.819）。

结论

水凝胶垫冷却组和水循环毯冷却组之间的神经学结果和不良事件相似。