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

Abstract

Background: 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.