本資料は、掲載誌(URI)等のリンク先にある学位授与機関のWebサイトやCiNii Dissertationsから、本文を自由に閲覧できる場合があります。
博士論文
国立国会図書館館内限定公開
収録元データベースで確認する
国立国会図書館デジタルコレクション
デジタルデータあり
公開元のウェブサイトで確認する
DOI[info:doi/10.1186/s13613-019-0603-y]のデータに遷移します
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
- 国立国会図書館永続的識別子
- info:ndljp/pid/11498637
国立国会図書館での利用に関する注記
資料に関する注記
一般注記:
- Background: The International Liaison Committee on Resuscitation guidelines recommend target temperature management (TTM) between 32 and 36 °C for pat...
書店で探す
書店で探す
書誌情報
この資料の詳細や典拠(同じ主題の資料を指すキーワード、著者名)等を確認できます。
デジタル
- 資料種別
- 博士論文
- 著者・編者
- 岡﨑, 智哉
- 著者標目
- 出版年月日等
- 2020-03-24
- 出版年(W3CDTF)
- 2020-03-24
- 授与機関名
- 香川大学
- 授与年月日
- 2020-03-24
- 授与年月日(W3CDTF)
- 2020-03-24
- 報告番号
- 甲第747号
- 学位
- 博士(医学)
- 博論授与番号
- 甲第747号
- 本文の言語コード
- eng
- 著者別名
- 対象利用者
- 一般
- 一般注記
- 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.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.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.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.
- DOI
- info:doi/10.1186/s13613-019-0603-y
- 国立国会図書館永続的識別子
- info:ndljp/pid/11498637
- コレクション(個別)
- 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
- 収集根拠
- 博士論文(自動収集)
- 受理日(W3CDTF)
- 2020-06-07T00:39:19+09:00
- 作成日(W3CDTF)
- 2020-10-27
- 記録形式(IMT)
- PDF
- オンライン閲覧公開範囲
- 国立国会図書館内限定公開
- デジタル化資料送信
- 図書館・個人送信対象外
- 遠隔複写可否(NDL)
- 可
- 原資料(URI)
- 連携機関・データベース
- 国立国会図書館 : 国立国会図書館デジタルコレクション