The Current Temperature: A Survey of Post-Resuscitation Management Across Australian and New Zealand Intensive Care Units

Introduction: Post-resuscitation care has changed dramatically over the last two decades –particularly target temperature management (TTM). However, uptake across Australian and New Zealand (NZ) intensive care units (ICUs) is currently unknown. Objectives: We aimed to describe the current status...

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Main Authors: Bray, Janet, Cartledge, Susie, Finn, Judith, Eastwood, Glen, McKenzie, Nicole, Stub, Dion, Straney, Lahn, Bernard, Stephen
Format: Conference Paper
Language:English
Published: ELSEVIER SCIENCE INC 2019
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/79486
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author Bray, Janet
Cartledge, Susie
Finn, Judith
Eastwood, Glen
McKenzie, Nicole
Stub, Dion
Straney, Lahn
Bernard, Stephen
author_facet Bray, Janet
Cartledge, Susie
Finn, Judith
Eastwood, Glen
McKenzie, Nicole
Stub, Dion
Straney, Lahn
Bernard, Stephen
author_sort Bray, Janet
building Curtin Institutional Repository
collection Online Access
description Introduction: Post-resuscitation care has changed dramatically over the last two decades –particularly target temperature management (TTM). However, uptake across Australian and New Zealand (NZ) intensive care units (ICUs) is currently unknown. Objectives: We aimed to describe the current status of post-resuscitation care in Australian and New Zealand ICUs. Methods: We conducted an online survey of 162 ICU medical directors in Australia (n=141) and NZ (n=21). The questionnaire consisted of multiple choice and open-ended responses. Results: Surveys were completed for 61 ICUs (50 Australian and 11 NZ). The majority if ICUs were in metropolitan regions (70%) and in were teaching hospitals (80%), with a range of hospital bed sizes (24-875) and ICU admissions (85-3000). Two ICUs did not admit post-arrest patients (excluded from further analysis). The majority of ICUs followed a post-resuscitation care guideline (70%). TTM was used in 57 (97%) hospitals –but only 64% had a TTM protocol and there was widespread variation in the types of patients treated, target temperatures (range=33-37.5C), methods for cooling and duration of cooling (range=12-72 hours). TTM is commenced pre-ICU in 18%. The majority (88%) changed TTM practice following the 2013 TTM trial publication (100% NZ and 85% Australia); with 28% targeting temperatures >36C and 50% expressed concerns with current level of evidence for TTM. Two-thirds (31/46) of directors had reviewed the ANZCOR (Australian and New Zealand Committee on Resuscitation) TTM guideline: 16 expressed concerns with current recommendations. Less than half (16/44, 36%) of ICUs had a protocol for prognostication and withdrawal of treatment. Conclusion(s): There is widespread variation in post-resuscitation care in Australian and New Zealand ICUs, and concerns with current TTM evidence and recommendations. Next, we intend to link this data to registries to examine the impact of this variation on outcomes.
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spelling curtin-20.500.11937-794862020-11-23T06:07:54Z The Current Temperature: A Survey of Post-Resuscitation Management Across Australian and New Zealand Intensive Care Units Bray, Janet Cartledge, Susie Finn, Judith Eastwood, Glen McKenzie, Nicole Stub, Dion Straney, Lahn Bernard, Stephen Science & Technology Life Sciences & Biomedicine Critical Care Medicine Nursing General & Internal Medicine Introduction: Post-resuscitation care has changed dramatically over the last two decades –particularly target temperature management (TTM). However, uptake across Australian and New Zealand (NZ) intensive care units (ICUs) is currently unknown. Objectives: We aimed to describe the current status of post-resuscitation care in Australian and New Zealand ICUs. Methods: We conducted an online survey of 162 ICU medical directors in Australia (n=141) and NZ (n=21). The questionnaire consisted of multiple choice and open-ended responses. Results: Surveys were completed for 61 ICUs (50 Australian and 11 NZ). The majority if ICUs were in metropolitan regions (70%) and in were teaching hospitals (80%), with a range of hospital bed sizes (24-875) and ICU admissions (85-3000). Two ICUs did not admit post-arrest patients (excluded from further analysis). The majority of ICUs followed a post-resuscitation care guideline (70%). TTM was used in 57 (97%) hospitals –but only 64% had a TTM protocol and there was widespread variation in the types of patients treated, target temperatures (range=33-37.5C), methods for cooling and duration of cooling (range=12-72 hours). TTM is commenced pre-ICU in 18%. The majority (88%) changed TTM practice following the 2013 TTM trial publication (100% NZ and 85% Australia); with 28% targeting temperatures >36C and 50% expressed concerns with current level of evidence for TTM. Two-thirds (31/46) of directors had reviewed the ANZCOR (Australian and New Zealand Committee on Resuscitation) TTM guideline: 16 expressed concerns with current recommendations. Less than half (16/44, 36%) of ICUs had a protocol for prognostication and withdrawal of treatment. Conclusion(s): There is widespread variation in post-resuscitation care in Australian and New Zealand ICUs, and concerns with current TTM evidence and recommendations. Next, we intend to link this data to registries to examine the impact of this variation on outcomes. 2019 Conference Paper http://hdl.handle.net/20.500.11937/79486 10.1016/j.aucc.2018.11.015 English ELSEVIER SCIENCE INC restricted
spellingShingle Science & Technology
Life Sciences & Biomedicine
Critical Care Medicine
Nursing
General & Internal Medicine
Bray, Janet
Cartledge, Susie
Finn, Judith
Eastwood, Glen
McKenzie, Nicole
Stub, Dion
Straney, Lahn
Bernard, Stephen
The Current Temperature: A Survey of Post-Resuscitation Management Across Australian and New Zealand Intensive Care Units
title The Current Temperature: A Survey of Post-Resuscitation Management Across Australian and New Zealand Intensive Care Units
title_full The Current Temperature: A Survey of Post-Resuscitation Management Across Australian and New Zealand Intensive Care Units
title_fullStr The Current Temperature: A Survey of Post-Resuscitation Management Across Australian and New Zealand Intensive Care Units
title_full_unstemmed The Current Temperature: A Survey of Post-Resuscitation Management Across Australian and New Zealand Intensive Care Units
title_short The Current Temperature: A Survey of Post-Resuscitation Management Across Australian and New Zealand Intensive Care Units
title_sort current temperature: a survey of post-resuscitation management across australian and new zealand intensive care units
topic Science & Technology
Life Sciences & Biomedicine
Critical Care Medicine
Nursing
General & Internal Medicine
url http://hdl.handle.net/20.500.11937/79486