Christian Storm1, J Nee2, Kjetil Sunde3, Michael Holzer4, Pia Hubner5, Fabio Silvio Taccone6, Hans Friberg7, Esteban Lopez-de-Sa8, Alain Cariou9, Joerg C Schefold10, Giuseppe Ristagno11, Marko Noc12, Dirk W Donker13, Janusz Andres14, Pawel Krawczyk15, Markus B Skrifvars16, James Penketh17, Alexander Krannich18, Michael Fries19. 1. Charité-Universitätsmedizin Berlin, Germany. Electronic address: christian.storm@charite.de. 2. Charité-Universitätsmedizin Berlin, Germany. Electronic address: jens.nee@charite.de. 3. Dept. of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Norway. Electronic address: kjetil.sunde@medisin.uio.no. 4. Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria. Electronic address: michael.holzer@meduniwien.ac.at. 5. Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria. Electronic address: pia.hubner@meduniwien.ac.at. 6. Dept. of Intensive Care, Erasme Hospital-Université Libre de Bruxelles (ULB) Brussels, Belgium. Electronic address: ftaccone@ulb.ac.be. 7. Dept. of Anesthesiology and Intensive Care Medicine, Skåne University Hospital, Lund University, Lund, Sweden. Electronic address: hans.a.friberg@gmail.com. 8. Dept. of Cardiology, La Paz-Idipaz University Hospital Madrid, Spain. Electronic address: e.lopezdesa@terra.com. 9. Medical Intensive Care Unit, Cochin Hospital (Assistance Publique Hôpitaux de Paris)-INSERM U970 (Team 4) and Paris Descartes University, France. Electronic address: alain.cariou.perso@gmail.com. 10. Dept. of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: joerg.schefold@insel.ch. 11. Dept. of Cardiovascular Research, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milan Italy and Italian Resuscitation Council, Bologna, Italy. Electronic address: gristag@gmail.com. 12. Centre of Intensive Internal Medicine, University Medical Centre, Ljubljana, Slovenia. Electronic address: marko.noc@mf.uni-lj.si. 13. Dept. of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: dirkdonker@ymail.com. 14. Dept. of Anaesthesiology and Intensive Care, Jagiellonian University Medical College Cracow, Poland. Electronic address: janusz.andres@uj.edu.pl. 15. Dept. of Anaesthesiology and Intensive Care, Jagiellonian University Medical College Cracow, Poland. Electronic address: p.krawczyk@uj.edu.pl. 16. Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Division of Intensive Care, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital, Finland. Electronic address: Markus.Skrifvars@hus.fi. 17. Dept. of Anaesthesia and Intensive Care Medicine, Royal United Hospital Bath, UK. Electronic address: jpenketh@nhs.net. 18. Charité-Universitätsmedizin Berlin, Germany. Electronic address: alexander.krannich@biostats.de. 19. Dept. of Anaesthesiology and Intensive Care Medicine, St. Vincenz-Hospital, Limburg, Germany, Germany. Electronic address: m.fries@st-vincenz.de.
Abstract
INTRODUCTION: International guidelines recommend a bundle of care, including targeted temperature management (TTM), in post cardiac arrest survivors. Aside from a few small surveys in different European countries, adherence to the European Resuscitation Council (ERC) and European Society of Intensive Care Medicine (ESICM) recommendations are unknown. METHODS: This international European telephone survey was conducted to provide an overview of current clinical practice of post cardiac arrest management with a main focus on TTM. We targeted large teaching and university hospitals within Europe as leading facilities and key opinion leaders in the field of post cardiac arrest care. Selected national principal investigators conducted the survey, which was based on a predefined questionnaire, between December 2014 and March 2015, before the publication of the ERC Guidelines 2015. RESULTS: The return rate was 94% from 268 participating intensive care units (ICU). The majority had a predefined standard operating procedure (SOP) protocol for post cardiac arrest patients. Altogether, 68% of the ICUs provided TTM at a target temperature of 32-34°C for 24h, and 33% had changed the target temperature to 36°C. The minority provided a written SOP for neurological prognostication, which was generally initiated 72h after return of spontaneous circulation (ROSC). Electroencephalography and somatosensory evoked potentials were used by most ICUs for early prognostication. Treating more than fifty patients a year was significantly associated with providing written SOPs for TTM and prognostication (p<0.01), as well as the use of a computer feedback device (p=0.03) for TTM. CONCLUSION: This international European telephone survey revealed a high rate of implementation of TTM in post cardiac arrest patients in university and teaching hospitals. Most participants also provided a SOP, but only a minority had a SOP for neurological prognostication.
INTRODUCTION: International guidelines recommend a bundle of care, including targeted temperature management (TTM), in post cardiac arrest survivors. Aside from a few small surveys in different European countries, adherence to the European Resuscitation Council (ERC) and European Society of Intensive Care Medicine (ESICM) recommendations are unknown. METHODS: This international European telephone survey was conducted to provide an overview of current clinical practice of post cardiac arrest management with a main focus on TTM. We targeted large teaching and university hospitals within Europe as leading facilities and key opinion leaders in the field of post cardiac arrest care. Selected national principal investigators conducted the survey, which was based on a predefined questionnaire, between December 2014 and March 2015, before the publication of the ERC Guidelines 2015. RESULTS: The return rate was 94% from 268 participating intensive care units (ICU). The majority had a predefined standard operating procedure (SOP) protocol for post cardiac arrestpatients. Altogether, 68% of the ICUs provided TTM at a target temperature of 32-34°C for 24h, and 33% had changed the target temperature to 36°C. The minority provided a written SOP for neurological prognostication, which was generally initiated 72h after return of spontaneous circulation (ROSC). Electroencephalography and somatosensory evoked potentials were used by most ICUs for early prognostication. Treating more than fifty patients a year was significantly associated with providing written SOPs for TTM and prognostication (p<0.01), as well as the use of a computer feedback device (p=0.03) for TTM. CONCLUSION: This international European telephone survey revealed a high rate of implementation of TTM in post cardiac arrestpatients in university and teaching hospitals. Most participants also provided a SOP, but only a minority had a SOP for neurological prognostication.
Authors: Jerry P Nolan; Robert A Berg; Clifton W Callaway; Laurie J Morrison; Vinay Nadkarni; Gavin D Perkins; Claudio Sandroni; Markus B Skrifvars; Jasmeet Soar; Kjetil Sunde; Alain Cariou Journal: Intensive Care Med Date: 2018-06-02 Impact factor: 17.440
Authors: Jerry P Nolan; Claudio Sandroni; Bernd W Böttiger; Alain Cariou; Tobias Cronberg; Hans Friberg; Cornelia Genbrugge; Kirstie Haywood; Gisela Lilja; Véronique R M Moulaert; Nikolaos Nikolaou; Theresa Mariero Olasveengen; Markus B Skrifvars; Fabio Taccone; Jasmeet Soar Journal: Intensive Care Med Date: 2021-03-25 Impact factor: 17.440
Authors: Lauri Wihersaari; Nicholas J Ashton; Matti Reinikainen; Pekka Jakkula; Ville Pettilä; Johanna Hästbacka; Marjaana Tiainen; Pekka Loisa; Hans Friberg; Tobias Cronberg; Kaj Blennow; Henrik Zetterberg; Markus B Skrifvars Journal: Intensive Care Med Date: 2020-08-27 Impact factor: 17.440