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Patients with extracorporeal membrane oxygenation and\/or continuous renal replacement therapy were classified as the extracorporeal group. We calculated the cooling rate during the induction period and time-weighted core temperatures (TWCT) during the maintenance period. We defined the sum of TWCT above or below 33\u00a0\u00b0C as positive and negative TWCT, respectively, and the sum of TWCT above 33.5\u00a0\u00b0C or below 32.5\u00a0\u00b0C as undercooling or overcooling, respectively. The primary outcome was the negative TWCT. The secondary outcomes were positive TWCT, cooling rate, undercooling, overcooling, and poor neurological outcomes, defined as Cerebral Performance Category 3\u20135. Among 235 patients, 150 (63.8%) had poor neurological outcomes and 52 (22.1%) were assigned to the extracorporeal group. The extracorporeal group (\u03b2, 0.307; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) had increased negative TWCT, rapid cooling rate (1.77\u00a0\u00b0C\/h [1.22\u20134.20] vs. 1.24\u00a0\u00b0C\/h [0.77\u20131.79]; <jats:italic>p<\/jats:italic>\u2009=\u20090.005), lower positive TWCT (33.4\u00a0\u00b0C\u2219min [24.9\u201346.2] vs. 54.6\u00a0\u00b0C\u2219min [29.9\u201387.0]), and higher overcooling (5.01\u00a0\u00b0C min [0.00\u201310.08] vs. 0.33\u00a0\u00b0C min [0.00\u20133.78]). However, the neurological outcome was not associated with the use of extracorporeal devices (odds ratio, 1.675; 95% confidence interval, 0.685\u20134.094).<\/jats:p>","DOI":"10.1038\/s41598-022-10196-x","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T13:04:41Z","timestamp":1649855081000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Heat loss augmented by extracorporeal circulation is associated with overcooling in cardiac arrest survivors who underwent targeted temperature management"],"prefix":"10.1038","volume":"12","author":[{"given":"Dong Hun","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byung Kook","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong Soo","family":"Cho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Ki","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seok Jin","family":"Ryu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin Hong","family":"Min","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung Soo","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung Woon","family":"Jeung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hwa Jin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun Song","family":"Youn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,4,13]]},"reference":[{"key":"10196_CR1","doi-asserted-by":"publisher","first-page":"S366","DOI":"10.1161\/CIR.0000000000000916","volume":"142","author":"AR Panchal","year":"2020","unstructured":"Panchal, A. 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