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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
https://kagawa-u.repo.nii.ac.jp/records/432
https://kagawa-u.repo.nii.ac.jp/records/432d8f43d82-1a61-449d-9ac5-addcfb6c3e83
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本文 (2.3 MB)
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内容の要旨 (64.0 kB)
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審査の結果の要旨 (89.6 kB)
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| Item type | 学位論文 / Thesis or Dissertation(1) | |||||||||||||
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| 公開日 | 2020-05-21 | |||||||||||||
| タイトル | ||||||||||||||
| タイトル | 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 | |||||||||||||
| 言語 | en | |||||||||||||
| 言語 | ||||||||||||||
| 言語 | eng | |||||||||||||
| 資源タイプ | ||||||||||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_db06 | |||||||||||||
| 資源タイプ | doctoral thesis | |||||||||||||
| アクセス権 | ||||||||||||||
| アクセス権 | open access | |||||||||||||
| アクセス権URI | http://purl.org/coar/access_right/c_abf2 | |||||||||||||
| 著者 |
岡﨑, 智哉
× 岡﨑, 智哉
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| 抄録 | ||||||||||||||
| 内容記述タイプ | Abstract | |||||||||||||
| 内容記述 | Background: The International Liaison Committee on Resuscitation guidelines recommend target temperature management (TTM) between 32 and 36 °C for patients after out-of-hospital cardiac arrest, but did not indicate patient-specific temperatures. The association of serum lactate concentration and neurological outcome in out-of-hospital cardiac arrest patient has been reported. The study aim was to investigate the benefit of 32-34 °C in patients with various degrees of hyperlactatemia compared to 35-36 °C. | |||||||||||||
| 言語 | en | |||||||||||||
| 抄録 | ||||||||||||||
| 内容記述タイプ | Abstract | |||||||||||||
| 内容記述 | Methods: This study was a post hoc analysis of the Japanese Association for Acute Medicine out-of-hospital cardiac arrest registry between June 2014 and December 2015. Patients with complete targeted temperature management and lactate data were eligible. Patients were stratified to mild (< 7 mmol/l), moderate (< 12 mmol/l), or severe (≥ 12 mmol/l) hyperlactatemia group based on lactate concentration after return of spontaneous circulation. They were subdivided into 32-34 °C or 35-36 °C groups. The primary endpoint was an adjusted predicted probability of 30-day favorable neurological outcome, defined as a cerebral performance category score of 1 or 2. | |||||||||||||
| 言語 | en | |||||||||||||
| 抄録 | ||||||||||||||
| 内容記述タイプ | Abstract | |||||||||||||
| 内容記述 | Result: Of 435 patients, 139 had mild, 182 had moderate, and 114 had severe hyperlactatemia. One hundred and eight (78%) with mild, 128 with moderate (70%), and 83 with severe hyperlactatemia (73%) received TTM at 32-34 °C. The adjusted predicted probability of a 30-day favorable neurological outcome following severe hyperlactatemia was significantly greater with 32-34 °C (27.4%, 95% confidence interval: 22.0-32.8%) than 35-36 °C (12.4%, 95% CI 3.5-21.2%; p = 0.005). The differences in outcomes in those with mild and moderate hyperlactatemia were not significant. | |||||||||||||
| 言語 | en | |||||||||||||
| 抄録 | ||||||||||||||
| 内容記述タイプ | Abstract | |||||||||||||
| 内容記述 | Conclusions: In OHCA patients with severe hyperlactatemia, the adjusted predicted probability of 30-day favorable neurological outcome was greater with TTM at 32-34 °C than with TTM at 35-36 °C. Further evaluation is needed to determine whether TTM at 32-34 °C can improve neurological outcomes in patients with severe hyperlactatemia after out-of-hospital cardiac arrest. | |||||||||||||
| 言語 | en | |||||||||||||
| 学位名 | ||||||||||||||
| 言語 | ja | |||||||||||||
| 学位名 | 博士（医学） | |||||||||||||
| 学位授与機関 | ||||||||||||||
| 識別子Scheme | kakenhi | |||||||||||||
| 識別子 | 16201 | |||||||||||||
| 言語 | ja | |||||||||||||
| 機関名 | 香川大学 | |||||||||||||
| 言語 | en | |||||||||||||
| 機関名 | Kagawa University | |||||||||||||
| 学位授与年月日 | ||||||||||||||
| 学位授与年月日 | 2020-03-24 | |||||||||||||
| 学位授与番号 | ||||||||||||||
| 学位授与番号 | 甲第747号 | |||||||||||||
| 権利 | ||||||||||||||
| 言語 | en | |||||||||||||
| 権利情報 | Copyright © 2019, The Author(s) | |||||||||||||
| 権利 | ||||||||||||||
| 言語 | en | |||||||||||||
| 権利情報Resource | http://creativecommons.org/licenses/by/4.0/ | |||||||||||||
| 権利情報 | This article is distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. | |||||||||||||
| 論文ID（NAID） | ||||||||||||||
| 識別子タイプ | NAID | |||||||||||||
| 関連識別子 | 500001381009 | |||||||||||||
| PubMed番号 | ||||||||||||||
| 識別子タイプ | PMID | |||||||||||||
| 関連識別子 | 31745738 | |||||||||||||
| 関連サイト | ||||||||||||||
| 関連タイプ | isVersionOf | |||||||||||||
| 識別子タイプ | DOI | |||||||||||||
| 関連識別子 | https://doi.org/10.1186/s13613-019-0603-y | |||||||||||||
| 関連サイト | ||||||||||||||
| 関連タイプ | isIdenticalTo | |||||||||||||
| 識別子タイプ | URI | |||||||||||||
| 関連識別子 | https://dl.ndl.go.jp/pid/11498637 | |||||||||||||
| 関連サイト | ||||||||||||||
| 関連タイプ | hasVersion | |||||||||||||
| 識別子タイプ | URI | |||||||||||||
| 関連識別子 | http://www.ncbi.nlm.nih.gov/pmc/articles/pmc6864017/ | |||||||||||||
| 助成情報 | ||||||||||||||
| 識別子タイプ | ISNI | |||||||||||||
| 助成機関識別子 | https://isni.org/isni/0000000463730043 | |||||||||||||
| 助成機関名 | 日本救急医学会 | |||||||||||||
| 言語 | ja | |||||||||||||
| 助成機関名 | Japanese Association for Acute Medicine | |||||||||||||
| 言語 | en | |||||||||||||
| 助成情報 | ||||||||||||||
| 識別子タイプ | Crossref Funder | |||||||||||||
| 助成機関識別子 | https://doi.org/10.13039/501100001691 | |||||||||||||
| 助成機関名 | 日本学術振興会 | |||||||||||||
| 言語 | ja | |||||||||||||
| 助成機関名 | Japan Society for the Promotion of Science | |||||||||||||
| 言語 | en | |||||||||||||
| 研究課題番号URI | https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-16K09034/ | |||||||||||||
| 研究課題番号 | 16K09034 | |||||||||||||
| 研究課題名 | 院外心停止患者の予後改善のためのバイオマーカーと高度集中治療の効果に関する研究 | |||||||||||||
| 言語 | ja | |||||||||||||
| 研究課題名 | Study regarding the effects of biomarkers and advanced intensive cares on the survival among patients with out-of-hospital cardiac arrest | |||||||||||||
| 言語 | en | |||||||||||||
| 助成情報 | ||||||||||||||
| 識別子タイプ | Crossref Funder | |||||||||||||
| 助成機関識別子 | https://doi.org/10.13039/501100001691 | |||||||||||||
| 助成機関名 | 日本学術振興会 | |||||||||||||
| 言語 | ja | |||||||||||||
| 助成機関名 | Japan Society for the Promotion of Science | |||||||||||||
| 言語 | en | |||||||||||||
| 研究課題番号URI | https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-15H05006/ | |||||||||||||
| 研究課題番号 | 15H05006 | |||||||||||||
| 研究課題名 | 院外心停止例の救命に寄与する要因の多面的分析と治療ストラテジの構築に関する研究 | |||||||||||||
| 言語 | ja | |||||||||||||
| 研究課題名 | Comprehensive Registry of Intensive Cares for OHCA Survival (CRITICAL) Study in Osaka, Japan | |||||||||||||
| 言語 | en | |||||||||||||
| 助成情報 | ||||||||||||||
| 識別子タイプ | Crossref Funder | |||||||||||||
| 助成機関識別子 | https://doi.org/10.13039/501100003478 | |||||||||||||
| 助成機関名 | 厚生労働省 | |||||||||||||
| 言語 | ja | |||||||||||||
| 助成機関名 | Ministry of Health, Labour and Welfare | |||||||||||||
| 言語 | en | |||||||||||||
| 研究課題番号 | 25112601 | |||||||||||||
| 著者版フラグ | ||||||||||||||
| 出版タイプ | P | |||||||||||||
| 出版タイプResource | http://purl.org/coar/version/c_fa2ee174bc00049f | |||||||||||||
| キーワード | ||||||||||||||
| 言語 | en | |||||||||||||
| 主題Scheme | Other | |||||||||||||
| 主題 | Out-of-hospital cardiac arrest | |||||||||||||
| キーワード | ||||||||||||||
| 言語 | en | |||||||||||||
| 主題Scheme | Other | |||||||||||||
| 主題 | Hyperlactatemia | |||||||||||||
| キーワード | ||||||||||||||
| 言語 | en | |||||||||||||
| 主題Scheme | Other | |||||||||||||
| 主題 | Targeted temperature management | |||||||||||||
| KEID | ||||||||||||||
| 28994 | ||||||||||||||
