Impact of two target body temperatures on inflammatory response, oxidative stress, cerebral metabolism, outcomes and complications in patients undergoing extracorporeal cardiopulmonary resuscitation

Objective To investigate the impact of two target body temperatures on inflammatory response, oxidative stress, cerebral metabolism, outcomes and complications in patients undergoing extracorporeal cardiopulmonary resuscitation.

Methods A retrospective analysis was conducted on the clinical data of 107 patients undergoing extracorporeal cardiopulmonary resuscitation. Fifty-three patients with a target body temperature controlled at 32.0 to 34.0 ℃ were included in the moderate hypothermia group, and 54 patients with a target body temperature controlled at 34.1 to 36.0 ℃ were included in the mild hypothermia group. Inflammatory response indicators C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1β (IL-1β), nuclear factor kappa-B subunit p65 (NF-κB p65), oxidative stress indicators superoxide dismutase (SOD), total antioxidant capacity (TAC), total oxidant status (TOS), malondialdehyde (MDA), and cerebral metabolism indicators arterial-jugular venous oxygen content difference (Da-jvO₂), cerebral oxygen extraction ratio (CERO₂) were compared between the two groups before temperature management and when the target temperature was achieved. Additionally, occurrence of complications and outcomes prognosis outcomes and Glasgow-Pittsburgh Cerebral Performance Categories (CPC) score were compared.

Results When the target temperature was achieved, the levels of CRP, IL-6, IL-1β, and NF-κB p65 in both groups were lower than those before temperature management, and their levels in the moderate hypothermia group were lower than those in the mild hypothermia group(P < 0.05). At the target temperature, the levels of SOD and TAC in both groups were higher than those before temperature management, and the levels in the moderate hypothermia group were higher than those in the mild hypothermia group (P < 0.05). Meanwhile, the levels of TOS and MDA in both groups were lower than those before temperature management, and the levels in the moderate hypothermia group were lower than those in the mild hypothermia group (P < 0.05). When the target temperature was achieved, the Da-jvO₂ and CERO₂ in both groups were lower than those before temperature management, and their levels in the moderate hypothermia group were lower than those in the mild hypothermia groups (P < 0.05). There was no statistically significant difference in the incidence of complications between the two groups (P>0.05). The CPC score and prognosis in the moderate hypothermia group were slightly better than those in the mild hypothermia group, but the difference was not statistically significant (P>0.05).

Conclusion Target body temperature management after cardiopulmonary resuscitation can effectively promote the recovery of cerebral function. A target body temperature of 32.0 to 34.0 ℃ is more conductive to reducing inflammatory response as well as oxidative stress, and improving cerebral metabolism and outcomes.