The influence of body composition on therapeutic hypothermia: a prospective observational study of patients after cardiac arrest.

Abstract:

INTRODUCTION:Patients after out-of-hospital cardiac arrest (OHCA) benefit from therapeutic hypothermia for 24 hours. The time needed to reach hypothermia (target temperature of 32 degrees C to 34 degrees C) varies widely. In this study, we explore the relation between measures of body composition and the time needed to reach target temperature with hypothermia. METHOD:We conducted a prospective observational study in patients treated with hypothermia after OHCA. Data collected included weight and height, body composition by anthropometric measures and by single-frequency body impedance, and waist-to-hip ratio. Analysis of concordance between impedance and anthropometric measures and hazard ratios of achieving target temperature (event) corrected for different body composition measures. RESULTS:Twenty-seven patients were included. The median (interquartile range) time to reach target temperature after admission to the intensive care unit was 191 (105 to 382) minutes. Intraclass correlation for total body fat (TBF) measures was 0.94 (95% confidence interval [CI] 0.89 to 0.97). Only TBF percentage (anthropometrics by the Durnin's table) appeared to be associated with time to reach target temperature: 0.93 (95% CI 0.87 to 0.99; P = 0.03). CONCLUSION:The body composition measures from single-frequency impedance and anthropometrics appear to be very concordant. Only TBF percentage (anthropometrics) showed a significant but clinically irrelevant influence on time needed to achieve target temperature with hypothermia. We conclude that there are no indications to adjust current cooling practice toward the body composition of patients.

journal_name

Crit Care

authors

Jimmink JJ,Binnekade JM,Paulus F,Mathus-Vliegen EM,Schultz MJ,Vroom MB

doi

10.1186/cc6954

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

R87

issue

4

eissn

1364-8535

issn

1466-609X

pii

cc6954

journal_volume

12

pub_type

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