The current temperature: A survey of post-resuscitation care across Australian and New Zealand intensive care units.

Aim: Targeted temperature management (TTM) in post-resuscitation care has changed dramatically over the last two decades. However, uptake across Australian and New Zealand (NZ) intensive care units (ICUs) is unclear. We aimed to describe post-resuscitation care in our region, with a focus on TTM, and to gain insights into clinician's opinions about the level of evidence supporting TTM.
Methods: In December 2017, we sent an online survey to 163 ICU medical directors in Australia (n ​= ​141) and NZ (n ​= ​22).
Results: Sixty-one ICU medical directors responded (50 from Australia and 11 from NZ). Two respondents were excluded from analysis as their Private ICUs did not admit post-arrest patients. The majority of remaining respondents stated their ICU followed a post-resuscitation care clinical guideline (n ​= ​41/59, 70%). TTM was used in 57 (of 59, 97%) ICUs, of these only 64% had a specific TTM clinical guideline/policy and there was variation in the types of patients treated, temperatures targeted (range ​= ​33-37.5 ​°C), methods for cooling and duration of cooling (range ​= ​12-72 ​h). The majority of respondents stated that their ICU (n ​= ​45/57, 88%) changed TTM practice following the TTM trial: with 28% targeting temperatures >36 ​°C, and 23 (of 46, 50%) respondents expressed concerns with current level of evidence for TTM. Only 38% of post-resuscitation guidelines included prognostication procedures, few ICUs reported the use of electrophysiological tests.
Conclusions: In Australian and New Zealand ICUs there is widespread variation in post-resuscitation care, including TTM practice and prognostication. There also seems to be concerns with current TTM evidence and recommendations.
Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(© 2020 The Author(s).)