Mild therapeutic hypothermia after cardiac arrest-A nationwide survey on the implementation of the ILCOR guidelines in German intensive care units

Sebastian Wolfrum, Peter W. Radke, Tobias Pischon, Stefan N. Willich, Heribert Schunkert, Volkhard Kurowski

Research output: Contribution to journalArticlepeer-review

123 Scopus citations

Abstract

Aim: To investigate the implementation of mild therapeutic hypothermia (MTH) after cardiac arrest into clinical practice. Methods and results: A structured evaluation questionnaire was sent to all German hospitals registered to have ICUs; 58% completed the survey. A total of 93 ICUs (24%) reported to use MTH. Of those, 93% started MTH in patients after out-of-hospital resuscitation with observed ventricular fibrillation and 72% when other initial rhythms were observed. Only a minority of ICUs initiate MTH in patients after cardiac arrest with cardiogenic shock (28%), whereas 48% regarded cardiogenic shock as a contra-indication for MTH. On average, target temperature was 33.1 ± 0.6 °C and duration of cooling 22.9 ± 4.9 h. Many centres used economically priced cold packs (82%) and cold infusions (80%) for cooling. The majority of the ICUs considered infection, hypotension and bleeding as relevant complications of hypothermia which was of therapeutic relevance in less than 25% of the cases. Conclusions: MTH is underused in German ICUs. Centres which use MTH widely follow the recommendations of ILCOR with respect to the indication and timing of cooling. In hospitals that use MTH the technique is considered to be safe and inexpensive. More efforts are needed to promote this therapeutic option and hypothermia since MTH has now been included into European advanced cardiovascular life support protocols.

Original languageEnglish
Pages (from-to)207-213
Number of pages7
JournalResuscitation
Volume72
Issue number2
DOIs
StatePublished - Feb 2007
Externally publishedYes

Keywords

  • Advanced life support (ALS)
  • Cardiac arrest
  • Cardiopulmonary resuscitation (CPR)
  • Out-of-hospital CPR
  • Sudden cardiac death

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