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. 2023 Jan 23;27(1):35.
doi: 10.1186/s13054-023-04319-7.

Temperature control in adults after cardiac arrest: a survey of current clinical practice in Germany

Kevin Roedl  1 , Sebastian Wolfrum  2 , Guido Michels  3 , Martin Pin  4 , Gerold Söffker  5 , Uwe Janssens  6 , Stefan Kluge  5
Affiliations

Temperature control in adults after cardiac arrest: a survey of current clinical practice in Germany

Kevin Roedl et al. Crit Care. .

Abstract

Background: Temperature control is recommended after out of hospital cardiac arrest (OHCA) by international guidelines. This survey aimed to investigate current clinical practice and areas of uncertainty.

Methods: Online survey targeting members of three medical emergency and critical care societies in Germany (April 21-June 6, 2022) assessing post-cardiac arrest temperature control management.

Results: Of 341 completed questionnaires 28% (n = 97) used temperature control with normothermic target and 72% (n = 244) temperature control with hypothermic target. The definition of fever regarding patients with cardiac arrest ranged from ≥ 37.7 to 39.0 °C. Temperature control was mainly started in the ICU (80%, n = 273) and most commonly core cooling (74%, n = 254) and surface cooling (39%, n = 134) with feedback were used. Temperature control was maintained for 24 h in 18% (n = 61), 48 h in 28% (n = 94), 72 h in 42% (n = 143) and longer than 72 h in 13% (n = 43). 7% (n = 24) were using different protocols for OHCA with initial shockable and non-shockable rhythm. Additional 14% (n = 48) were using different temperature control protocols after in-hospital cardiac arrest (IHCA) compared with OHCA. Overall, 37% (n = 127) changed practice after the publication of the ERC-2021 guidelines and 33% (n = 114) after the recent publication of the revised ERC-ESICM guideline on temperature control.

Conclusions: One-third of the respondents changed clinical practice since recent guideline update. However, a majority of physicians further trusts in temperature control with a hypothermic target. Of interest, 14% used different temperature control strategies after IHCA compared with OHCA and 7% for shockable and non-shockable initial rhythm. A more individualized approach in post resuscitation care may be warranted.

Keywords: Cardiac arrest; Clinical practice; Hypothermia; Targeted temperature management; Temperature control.

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Conflict of interest statement

KR, SW, MP, GS and UJ declare that they have no competing interests. GM received lecture honoraria from Getinge and Orion Pharma. SK received research support from Cytosorbents and Daiichi Sankyo. He also received lecture fees from ADVITOS, Biotest, Daiichi Sankyo, Fresenius Medical Care, Gilead, Mitsubishi Tanabe Pharma, MSD, Pfizer and Zoll. He received consultant fees from Fresenius, Gilead, MSD and Pfizer.

Figures

Fig. 1
Fig. 1
A Definition of fever used in patients with cardiac arrest; B Temperature control target-stratified according temperature control with normothermic and hypothermic target; C Cooling methods used by the survey participants
See this image and copyright information in PMC

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