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Updated: Nov 19, 2025
Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
Intermittent versus continuous neuromuscular blockade during target temperature management after cardiac arrest: A
Toru Takiguchi1, Hiroyuki Ohbe2, Mikio Nakajima3
1Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.
Purpose:
Whether intermittent or continuous neuromuscular-blocking agents (NMBAs) would be appropriate during target temperature management (TTM) after cardiac arrest remains unclear.
Materials And Methods:
In this retrospective cohort study, we utilized the Japanese Diagnosis Procedure Combination inpatient database from July 2010 to March 2018 and identified patients who received NMBAs during TTM after cardiac arrest on the day of admission. We compared the in-hospital mortality between the propensity-score-matched intermittent and continuous NMBA groups.
Results:
We identified 5584 eligible patients; 1488 received intermittent NMBAs and 4096 received continuous NMBAs. After propensity score matching, there was no significant difference in the in-hospital mortality between the intermittent and continuous NMBA groups (32.9% vs. 33.1%; odds ratio, 0.98; 95% confidence interval, 0.82-1.18). In subgroup analyses, in-hospital mortality of the continuous NMBA group was significantly higher than that of the intermittent NMBA group in patients aged ≥65 years (p for interaction = 0.021).
Conclusions:
This large retrospective study did not suggest that intermittent NMBAs may be inferior to continuous NMBAs in terms of mortality reduction in the overall population receiving TTM for cardiac arrest. However, continuous NMBAs may be inferior to intermittent NMBAs for reducing mortality in elderly patients.
