Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 8, November, p. 1207–1212

doi: 10.17219/acem/66992

Publication type: original article

Language: English

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Implementation of mild therapeutic hypothermia for post-resuscitation care of sudden cardiac arrest survivors in cardiology units in Poland

Łukasz Kołtowski1,A,B,C,D,E,F, Karolina Malesa1,B,C,D,F, Mariusz Tomaniak1,A,C,E,F, Janina Stępińska2,A,C,E,F, Beata Średniawa3,A,C,E,F, Paulina Karolczyk1,A,B,C,F, Dominika Puchta1,A,B,C,F, Robert Kowalik1,A,C,D,F, Elżbieta Kremis2,A,B,C,E,F, Krzysztof J. Filipiak1,A,C,E,F, Marek Banaszewski2,A,B,E,F, Grzegorz Opolski1,A,C,E,F, Marta Bagińska1,D

1 1st Department of Cardiology, Medical University of Warsaw, Poland

2 Intensive Cardiac Care Clinic, Institute of Cardiology, Warszawa, Poland

3 Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland

Abstract

Background. The post-cardiac arrest (CA) period is often associated with secondary damage of the brain that leads to severe neurological deficits. The current practice guidelines recommend the use of therapeutic hypothermia (TH) to prevent neurological deficit and improve survival.
Objectives. The aim of the study was to investigate the implementation of medical guidelines in clinical practice and to evaluate the barriers for implementation of TH in cardiology units in Poland.
Material and Methods. A telephone survey, fax and online inquiry form were used to assess the implementation of TH in cardiology units in the management of unconscious patients after cardiac arrest (CA). The questions addressed the local practice, TH protocol, reasons for not using TH and outcomes of CA patients.
Results. We obtained information from 79 units out of 150 asked (53%). At the time of the survey, 24 units (30.8%) were using TH as part of their post-CA management. Of all CA patients, 45% underwent TH in cardiac intensive care units (CICU), 37.5% in the coronary care unit (CCU) and 12.5% in the intensive care unit (ICU). The major barrier for the implementation of TH declared by the non-cooling centers was lack of sufficient knowledge regarding the technique and protocol, as well as experience (37%); access to dedicated equipment was not perceived as an obstacle.
Conclusion. The number of cardiology units that provide TH for comatose CA patients is low. The main limiting factor for wider use of TH is lack of knowledge and experience. There is a clear need for urgent educational activities for cardiology units. The benefits of TH still have not reached their potential in cardiology units.

Key words

cardiac arrest, therapeutic hypothermia, resuscitation, hypothermia registry, target temperature management

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