Nicola Gasparetto1, Daniele Scarpa2, Sandra Rossi3, Paolo Persona3, Luigi Martano4, Andrea Bianchin5, Carlo Alberto Castioni6, Carlo Ori3, Sabino Iliceto2, Luisa Cacciavillani2. 1. Cardiology Clinic, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padua, via Giustiniani 2, 35128 Padua, Italy. Electronic address: gasparetto.nicola@gmail.com. 2. Cardiology Clinic, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padua, via Giustiniani 2, 35128 Padua, Italy. 3. Anaesthesia and Intensive Care Institute, Department of Medicine, University Hospital of Padua, via Cesare Battisti 267, 35128 Padua, Italy. 4. Emergency Department, University Hospital of Padua, via Giustiniani 2, 35128 Padua, Italy. 5. Anaesthesia and Intensive Care Unit, S. Valentino Hospital, via Togliatti 1, 31044 Montebelluna, Treviso, Italy. 6. Intensive Care Unit, ASL TO 4, S. Giovanni Bosco Hospital, Piazza Donatore di Sangue 3, 10154 Turin, Italy.
Abstract
BACKGROUND: Therapeutic hypothermia (TH) is one of three interventions that have demonstrated to improve patients' neurological outcome after cardiac arrest. The aim of this study was to investigate the effect of the 2010 resuscitation guidelines on TH implementation in various Italian Intensive Care Units (ICU). METHODS: A structured questionnaire was submitted to Italian ICU. The questionnaire was addressed to determine the procedures of TH in each ICU or, on the contrary, the reason for not employing the therapy. RESULTS: We obtained complete information from 770 of 847 Italian ICU (91%). Out of 405 Units included in the analysis only 223 (55.1%) reported to use TH in comatose patients after return of spontaneous circulation. The trend of TH implementation shows a stable increase, particularly after 2006 but there is no evident acceleration after the strong indication of the 2010 guidelines. There was a rise of about 3.4 times in the number of Italian ICU using TH as compared to the 2007 survey (an increase of 68% per year). One hundred and eighty-two (44.9%) units did not use TH mainly because of lack of equipment, economic issues or the conviction of the difficulty of execution. CONCLUSIONS: TH is still under-used in Italy (55.1%) even though the therapy is strongly recommended in the 2010 guidelines. However, the increase in the adoption of hypothermia has been significant in the past 5 years (68%/years) and the awareness of the efficacy is almost consolidated among intensivists, being logistic problems the leading cause for non-adoption.
BACKGROUND: Therapeutic hypothermia (TH) is one of three interventions that have demonstrated to improve patients' neurological outcome after cardiac arrest. The aim of this study was to investigate the effect of the 2010 resuscitation guidelines on TH implementation in various Italian Intensive Care Units (ICU). METHODS: A structured questionnaire was submitted to Italian ICU. The questionnaire was addressed to determine the procedures of TH in each ICU or, on the contrary, the reason for not employing the therapy. RESULTS: We obtained complete information from 770 of 847 Italian ICU (91%). Out of 405 Units included in the analysis only 223 (55.1%) reported to use TH in comatosepatients after return of spontaneous circulation. The trend of TH implementation shows a stable increase, particularly after 2006 but there is no evident acceleration after the strong indication of the 2010 guidelines. There was a rise of about 3.4 times in the number of Italian ICU using TH as compared to the 2007 survey (an increase of 68% per year). One hundred and eighty-two (44.9%) units did not use TH mainly because of lack of equipment, economic issues or the conviction of the difficulty of execution. CONCLUSIONS: TH is still under-used in Italy (55.1%) even though the therapy is strongly recommended in the 2010 guidelines. However, the increase in the adoption of hypothermia has been significant in the past 5 years (68%/years) and the awareness of the efficacy is almost consolidated among intensivists, being logistic problems the leading cause for non-adoption.
Authors: Nicolas Deye; François Vincent; Philippe Michel; Stephan Ehrmann; Daniel da Silva; Michael Piagnerelli; Antoine Kimmoun; Olfa Hamzaoui; Jean-Claude Lacherade; Bernard de Jonghe; Florence Brouard; Corinne Audoin; Xavier Monnet; Pierre-François Laterre Journal: Ann Intensive Care Date: 2016-01-12 Impact factor: 6.925