Implementation of targeted temperature management after cardiac arrest in Polish intensive care units. What has changed in the last five years?

Abstract

A b s t r a c tBackground: Studies conducted up to 2010 indicate the underuse of targeted temperature management (TTM) in Poland. Aim:This study evaluated the current degree of TTM implementation in Polish intensive care units (ICUs) and analysed the implementation process since 2010. Methods:A telephone survey, conducted from December 2014 to July 2015, was carried out to determine the number of ICUs using TTM in patients after cardiac arrest. We collected data on the details and prevalence of TTM, and the impact of organisational and financial issues and recently published papers on its use. Results:We obtained data from 271 of 396 ICUs (68.4%). In total, 79 (29.2%) ICUs indicated TTM use and 27 (34.2%) used dedicated TTM equipment. Overall, 62% of the ICUs used TTM regardless of the cardiac arrest rhythm. Target temperatures of 32-34°C and 34.1-36°C were reached by 44.3% and 43.0% of ICUs, respectively. The duration of TTM was 12-24 h in 58.2% of the ICUs. The most common barriers to TTM implementation were a lack of dedicated devices (36.3%) and organisational and logistical issues (31.2%). Any influence of recently published data on TTM practice modifications was reported by only 23.4% of the ICUs. Conclusions:Targeted temperature management is underused in Polish ICUs. There is a need for additional educational and implementation efforts supporting the translation of knowledge into clinical practice at the regional and national levels.

Predicting survival in out-of-hospital cardiac arrest patients undergoing targeted temperature management: The Polish Hypothermia Registry Risk Score

“…Krawczyk et al [17] emphasised the need for discussion and education when they reported that the TTM procedure in Polish ICUs is underused. The most common limitations include a lack of dedicated devices, logistical issues and a misunderstanding or misinterpretation of published evidence.…”

Efficacy and safety of prolonged mild therapeutic hypothermia treatment in patients after out-of-hospital cardiac arrest: preliminary data

“…Results of a recent survey study showed that the prevalence of TTM in Poland is still low. Only about one-third of the intensive care units that responded to the survey use such a method [1].…”