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ERC-ESICM guidelines on temperature control after cardiac arrest in adults

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Nolan, Jerry P., Sandroni, Claudio, Andersen, Lars W., Böttiger, Bernd W., Cariou, Alain, Cronberg, Tobias, Friberg, Hans, Genbrugge, Cornelia, Lilja, Gisela, Morley, Peter T., Nikolaou, Nikolaos, Olasveengen, Theresa M., Skrifvars, Markus B., Taccone, Fabio S. and Soar, Jasmeet (2022) ERC-ESICM guidelines on temperature control after cardiac arrest in adults. Resuscitation, 172 . pp. 229-236. doi:10.1016/j.resuscitation.2022.01.009 ISSN 0300-9572.

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Official URL: http://dx.doi.org/10.1016/j.resuscitation.2022.01....

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Abstract

The aim of these guidelines is to provide evidence‑based guidance for temperature control in adults who are comatose after resuscitation from either in-hospital or out-of-hospital cardiac arrest, regardless of the underlying cardiac rhythm. These guidelines replace the recommendations on temperature management after cardiac arrest included in the 2021 post-resuscitation care guidelines co-issued by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM).

The guideline panel included thirteen international clinical experts who authored the 2021 ERC-ESICM guidelines and two methodologists who participated in the evidence review completed on behalf of the International Liaison Committee on Resuscitation (ILCOR) of whom ERC is a member society. We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence and grade recommendations. The panel provided suggestions on guideline implementation and identified priorities for future research.

The certainty of evidence ranged from moderate to low. In patients who remain comatose after cardiac arrest, we recommend continuous monitoring of core temperature and actively preventing fever (defined as a temperature > 37.7 °C) for at least 72 hours. There was insufficient evidence to recommend for or against temperature control at 32–36 °C or early cooling after cardiac arrest. We recommend not actively rewarming comatose patients with mild hypothermia after return of spontaneous circulation (ROSC) to achieve normothermia. We recommend not using prehospital cooling with rapid infusion of large volumes of cold intravenous fluids immediately after ROSC.

Item Type: Journal Article
Subjects: R Medicine > RB Pathology
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Cardiac arrest, Coma , Prognosis , Hypothermia
Journal or Publication Title: Resuscitation
Publisher: Elsevier Ireland Ltd
ISSN: 0300-9572
Official Date: March 2022
Dates:
DateEvent
March 2022Published
11 February 2022Available
4 January 2022Accepted
Volume: 172
Page Range: pp. 229-236
DOI: 10.1016/j.resuscitation.2022.01.009
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 15 August 2022
Date of first compliant Open Access: 15 August 2022

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