목표체온유지치료를 적용한 심정지 후 증후군 환자에서 반동성 고체온 발생군과 비발생군의 임상결과 비교

Abstract

Purpose This retrospective study aims to provide basic data for intervention to improve clinical outcomes and identify the characteristics of the rebound hyperthermia (RHG) and non-rebound hyperthermia(NRHG) groups by checking body temperature in patients with postcardiac arrest syndrome.

Method The study involved 118 patients who completed target temperature management (TTM) in an acute-care unit. Data were analyzed for frequency, percentages, mean, standard deviation, median, and quartiles, and compared using the chi-squared test and Mann–Whitney U-test.

Results Rebound hyperthermia (RH) was observed in 74 (62.7%) patients, predominantly male(69.5%), with an average age of 64.54±15.98, and a body mass index of 23.22± 4.75kg/m2(overweight). Hypertension (50%) was the most common co-morbidity, followed by diabetes and heart disease (33.1%). Neuron-specific enolase levels were higher in the NRHG 24, 48, and 72 hours after recovery of spontaneous circulation (p = .037, p ＜ .001, p = .008). The APHCHE Ⅳ was also higher in the NRHG (p ＜ .001). RH occurred 25.49 (7.28–52.96) hours after TTM completion, lasting for 2 (1–3) hours. Temperature reduction strategies included notifying doctors, administering antipyretics, and nursing intervention, with the latter being the most common at 94.6%. Half of the subjects in the RHG and 77.3% in the NRHG fell into cerebral performance categories 3, 4, and 5 (p=.003).

Conclusion RH is more likely a body mechanism related to CPR and TTM than a result of pathogenic infection. Therefore, we require an active intervention for hyperthermia, and a patient-specific nursing intervention protocol.