{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T14:40:03Z","timestamp":1781188803154,"version":"3.54.1"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T00:00:00Z","timestamp":1663113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Dong-A University Research Fund"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Guidelines have recommended monitoring mean arterial pressure (MAP) and systolic arterial pressure (SAP) in cardiac arrest patients, but there has been relatively little regard for diastolic arterial pressure (DAP) and heart rate (HR). We aimed to determine the prognostic significance of hemodynamic parameters at all time points during targeted temperature management (TTM).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We reviewed the SAP, DAP, MAP, and HR data in out-of-hospital cardiac arrest (OHCA) survivors from the prospective multicenter registry of 22 teaching hospitals. This study included 1371 patients who underwent TTM among 10,258 cardiac arrest patients. The hemodynamic parameters were recorded every 6 hours from the return of spontaneous circulation (ROSC) to 4 days. The risks of those according to time points during TTM were compared.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of the included patients, 943 (68.8%) had poor neurological outcomes. The predictive ability of DAP surpassed that of SAP and MAP at all time points, and among the hemodynamic variables HR\/DAP was the best predictor of the poor outcome. The risks in patients with DAP &lt; 55 to 70 mmHg and HR &gt; 70 to 100 beats\/min were steeply increased for 2 days after ROSC and correlated with the poor outcome at all time points. Bradycardia showed lower risks only at 6 hours to 24 hours after ROSC.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Hemodynamic parameters should be intensively monitored especially for 2 days after ROSC because cardiac arrest patients may be vulnerable to hemodynamic instability during TTM. Monitoring HR\/DAP can help access the risks in cardiac arrest patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0274130","type":"journal-article","created":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T17:54:27Z","timestamp":1663178067000},"page":"e0274130","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Heart rate and diastolic arterial pressure in cardiac arrest patients: A nationwide, multicenter prospective registry"],"prefix":"10.1371","volume":"17","author":[{"given":"Chul","family":"Han","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5815-6994","authenticated-orcid":true,"given":"Jae Hoon","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Korean Hypothermia Network Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"pone.0274130.ref001","doi-asserted-by":"crossref","first-page":"S366","DOI":"10.1161\/CIR.0000000000000916","article-title":"Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care","volume":"142","author":"AR Panchal","year":"2020","journal-title":"Circulation"},{"key":"pone.0274130.ref002","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1007\/s00134-013-3075-9","article-title":"Higher mean arterial pressure with or without vasoactive agents is associated with increased survival and better neurological outcomes in comatose survivors of cardiac arrest","volume":"39","author":"ME Beylin","year":"2013","journal-title":"Intensive Care Med"},{"key":"pone.0274130.ref003","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.resuscitation.2018.07.017","article-title":"The impact of diastolic blood pressure values on the neurological outcome of cardiac arrest patients","volume":"130","author":"F Annoni","year":"2018","journal-title":"Resuscitation"},{"key":"pone.0274130.ref004","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1093\/eurheartj\/ehi179","article-title":"Risk factors for out-of-hospital cardiac arrest: the Reykjavik Study","volume":"26","author":"G Thorgeirsson","year":"2005","journal-title":"European heart journal"},{"key":"pone.0274130.ref005","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s13613-020-00658-8","article-title":"Diastolic shock index and clinical outcomes in patients with septic shock","volume":"10","author":"GA Ospina-Tasc\u00f3n","year":"2020","journal-title":"Annals of intensive care"},{"key":"pone.0274130.ref006","first-page":"1188","article-title":"Diastolic arterial blood pressure: a reliable early predictor of survival in human septic shock","volume":"64","author":"S Benchekroune","year":"2008","journal-title":"The Journal of trauma"},{"key":"pone.0274130.ref007","doi-asserted-by":"crossref","first-page":"2484","DOI":"10.1097\/CCM.0b013e3182982ac3","article-title":"The short-term prognosis of cardiogenic shock can be determined using hemodynamic variables: a retrospective cohort study*","volume":"41","author":"F Rigamonti","year":"2013","journal-title":"Crit Care Med"},{"key":"pone.0274130.ref008","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.resuscitation.2017.07.009","article-title":"Association of hemodynamic variables with in-hospital mortality and favorable neurological outcomes in post-cardiac arrest care with targeted temperature management","volume":"120","author":"CH Huang","year":"2017","journal-title":"Resuscitation"},{"key":"pone.0274130.ref009","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1111\/j.1553-2712.1996.tb03351.x","article-title":"Shock index as a marker for significant injury in trauma patients","volume":"3","author":"RW King","year":"1996","journal-title":"Academic emergency medicine: official journal of the Society for Academic Emergency Medicine"},{"key":"pone.0274130.ref010","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/0300-9572(92)90006-X","article-title":"Shock index: a re-evaluation in acute circulatory failure","volume":"23","author":"MY Rady","year":"1992","journal-title":"Resuscitation"},{"key":"pone.0274130.ref011","doi-asserted-by":"crossref","first-page":"179","DOI":"10.2147\/OAEM.S178358","article-title":"Shock index in the emergency department: utility and limitations. 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