The following is a summary of “Practice survey on recent changes in post cardiac arrest care and temperature management in French intensive care units,” published in the December 2024 issue of Critical Care by Haddadi et al.
Recent guidelines for post-cardiac arrest (CA) management have undergone significant changes, shifting from hypothermia to temperature control in targeted therapeutic management (TTM).
Researchers conducted a retrospective study to assess the changes in post-CA management in French intensive care units (ICUs) following new recommendations.
They implemented 2 declarative web surveys from March to August 2023, comparing the doctors’ survey with a previously published 1 from 2015. A total of 389 departments from 276 French centers were contacted.
The results showed that 334 physicians from 189 ICUs participated, TTM was used by 95.5% of respondents, with 64% using temperature feedback devices. Multivariate analysis found that temperature feedback use was linked to university hospital responders [OR 1.99 (1.19–3.34, P = 0.009)], high cardiac arrest admissions rate [OR 2.25 (1.13–4.78, P = 0.026)], written procedures [OR 1.76 (1.07–2.92, P = 0.027)], and presence of cath-lab for coronary angiography [OR 2.42 (1.33–4.44, P = 0.004)]. The targeted temperature shifted from 32–34°C in 2015 to 35–36°C in 2023 (P < 0.001). Proportions of TTM with temperature feedback devices increased from 45% to 65% (P < 0.001). In total, 660 nurses from 150 ICUs responded, with gel-coated water circulating pads and intravascular cooling rated as the most effective and adjustable devices by TTM users.
Investigators concluded that, despite increased use of temperature feedback devices, the latest post-resuscitation care and TTM recommendations were not fully implemented, with significant variability in TTM systems and lack of temperature feedback in many ICUs.
Source: sciencedirect.com/science/article/abs/pii/S0883944124003903
