Abstract 15675: Variability in Post-Arrest Targeted Temperature Management Practice in the US: 33°C vs. 36°C
Background: A recent study examining 33C vs 36C use in Targeted Temperature Management (TTM) after cardiac arrest showed equivalent outcomes. However, it is unclear whether providers are changing goal target temperature based on these findings.
Objectives: To characterize the state of TTM practice in US hospitals and to assess whether institutions are using a goal temperature of 33C or 36C.
Methods: A 10-question internet-based survey was sent to a convenience sample of healthcare providers throughout the US. Providers associated with the Penn Alliance for Therapeutic Hypothermia database, Hypothermia and Resuscitation Training Institute, and other resuscitation specific email lists were included. Participants were queried regarding their institution’s TTM protocol. Descriptive analyses were performed.
Results: Between 12/2014-05/2015, 219 healthcare providers responded from 112 institutions in 35 states. Respondents were staff nurses (39%), advanced practice nurses (28%), physicians (22%) and other providers (11%). Respondents represented medical ICU (25%), cardiac ICU (21%), ED (15%), and other ICUs (39%).
When asked about their institution’s TTM protocol, of those who responded (204/219), 65% reported a goal temperature of 33C, 8% reported 36C, 25% reported either 33C or 36C, and 3% were unknown. When asked how the target temperature was selected, 30% stated there were only adequate data to support 33C, 3% stated there were only adequate data supporting 36C, 42% stated they were reevaluating 33C v 36C, and 25% stated unknown.
A median of 2 (IQR 2-3.5) clinicians from the same institution completed the survey. Of those, 5/39 (13%) of the respondents from the same institution did not agree on or were unsure whether their institution had a TTM protocol; 33% did not agree on the target temperature within their hospital; 64% did not agree or did not know if data supported the instruction’s choice of target temperature.
Conclusions: Across hospitals in the US, and even within the same institution, the target temperature for post-arrest patients varies widely. More research is required to understand the choice of TTM target temperature for specific patient indications to improve outcomes.
Author Disclosures: M. Leary: Research Grant; Significant; American Heart Association, Laerdal Foundation. Other Research Support; Modest; Laerdal, Physio-control. Ownership Interest; Modest; Resuscor, LLC. Consultant/Advisory Board; Modest; Stryker Medical. G. Delfin: None. A. Grossestreuer: Research Grant; Significant; American Heart Association. B. Bobrow: Research Grant; Significant; Medtronic Foundation. J. Santos: None. D. Buckler: None. B.S. Abella: Research Grant; Significant; PCORI, NIH NHLBI, Philips Healthcare, Medtronic Foundation, Stryker Medical. Honoraria; Modest; Bard, Stryker. Ownership Interest; Modest; Resuscor, LLC. Consultant/Advisory Board; Modest; Velomedex, HeartSine Corp. A. Blewer: Research Grant; Significant; American Heart Association. Ownership Interest; Modest; Resuscor, LLC.
- © 2015 by American Heart Association, Inc.