Department of Intensive Care Medicine and Nephrology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany.
Department of Intensive Care Medicine and Nephrology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany.
Resuscitation. 2014 Aug;85(8):1012-7. doi: 10.1016/j.resuscitation.2014.04.023. Epub 2014 May 2.
Target temperature management (TTM) after cardiac arrest is recommended by international guidelines, which have been last updated in 2010. Here we investigate the status of implementation in a nationwide survey in Germany which took place in 2012.
We conducted a nationwide telephone survey including a total of 951 German intensive care units (ICUs). ICUs were identified by using the online registry for hospitals in Germany. A questionnaire was used for the interview about basic data of the intensive care unit and about details concerning use and implementation of TTM after cardiac arrest.
The overall response rate was 91% (865/951). 86% (742/865) of ICUs used TTM after cardiac arrest and implementation peaked in 2010. 95% (702/736) of the ICUs using TTM perform treatment independently of the initial rhythm and 48% (355/738) apply TTM with the use of a feedback device for cooling and controlled re-warming. However, 22% (166/742) still use conventional methods like ice and cold infusion and only 61% (453/742) of the participants provided a written standard operating procedure (SOP).
With a delay of several years, TTM after cardiac arrest is now implemented in the majority of German ICUs. The moderate proportion of ICUs using SOPs for TTM and feedback-controlled cooling devices indicates the need of further improvement in post cardiac arrest care.
国际指南推荐心脏骤停后进行目标温度管理（TTM），该指南的最后一次更新时间是 2010 年。在此，我们在 2012 年进行了一项全国范围的调查，以研究德国的实施现状。
我们进行了一项全国性的电话调查，共包括 951 家德国重症监护病房（ICU）。通过使用德国医院在线登记系统来识别 ICU。调查问卷用于访谈 ICU 的基本数据以及心脏骤停后 TTM 的使用和实施细节。
总应答率为 91%（865/951）。86%（742/865）的 ICU 在心脏骤停后使用 TTM，实施高峰期在 2010 年。95%（702/736）使用 TTM 的 ICU 独立于初始节律进行治疗，48%（355/738）使用反馈设备进行冷却和控制性复温。然而，仍有 22%（166/742）的 ICU 仍使用传统方法，如冰和冷输注，只有 61%（453/742）的参与者提供了书面的标准操作程序（SOP）。
心脏骤停后 TTM 的实施在德国的大多数 ICU 中已经延迟了几年。使用 SOP 和反馈控制冷却设备的 ICU 的比例适中，表明在心脏骤停后护理方面仍需进一步改进。
