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Management of comatose survivors of out-of-hospital cardiac arrest in Europe : current treatment practice and adherence to guidelines. A joint survey by the Association for Acute CardioVascular Care (ACVC) of the ESC, the European Resuscitation Council (ERC), the European Society for Emergency Medicine (EUSEM), and the European Society of Intensive Care Medicine (ESICM)
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Jorge-Perez, Pablo, Nikolaou, Nikolaos, Donadello, Katia, Khoury, Abdo, Behringer, Wilhelm, Hassager, Christian, Boettiger, Bernd, Sionis, Alessandro, Nolan, Jerry P., Combes, Alain, Quinn, Tom, Price, Susanna and Grand, Johannes (2023) Management of comatose survivors of out-of-hospital cardiac arrest in Europe : current treatment practice and adherence to guidelines. A joint survey by the Association for Acute CardioVascular Care (ACVC) of the ESC, the European Resuscitation Council (ERC), the European Society for Emergency Medicine (EUSEM), and the European Society of Intensive Care Medicine (ESICM). European Heart Journal. Acute Cardiovascular Care, 12 (2). pp. 96-105. doi:10.1093/ehjacc/zuac153 ISSN 2048-8734.
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Official URL: https://doi.org/10.1093/ehjacc/zuac153
Abstract
Aims International guidelines give recommendations for the management of comatose out-of-hospital cardiac arrest (OHCA) survivors. We aimed to investigate adherence to guidelines and disparities in the treatment of OHCA in hospitals in Europe. Methods and results A web-based, multi-institutional, multinational survey in Europe was conducted using an electronic platform with a predefined questionnaire developed by experts in post-resuscitation care. The survey was disseminated to all members of the societies via email, social media, websites, and newsletters in June 2021. Of 252 answers received, 237 responses from different units were included and 166 (70%) were from cardiac arrest centres. First-line vasopressor used was noradrenaline in 195 (83%) and the first-line inotrope was dobutamine in 148 (64%) of the responses. Echocardiography is available 24/7 in 204 (87%) institutions. Targeted temperature management was used in 160 (75%) institutions for adult comatose survivors of OHCA with an initial shockable rhythm. Invasive or external cooling methods with feedback were used in 72 cardiac arrest centres (44%) and 17 (24%) non-cardiac arrest centres (P < 0.0003). A target temperature between 32 and 34°C was preferred by 46 centres (21%); a target between 34 and 36°C by 103 centres (52%); and <37.5°C by 35 (16%). Multimodal neuroprognostication was poorly implemented and a follow-up at 3 months after discharge was done in 71 (30%) institutions. Conclusion Post-resuscitation care is not well established and varies among centres in European hospitals. Cardiac arrest centres have a higher coherence with guidelines compared with respondents from non-cardiac arrest centres. The overall inconsistency in approaches and deviation from recommendations could be a focus for improvement.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||||
SWORD Depositor: | Library Publications Router | ||||||||
Library of Congress Subject Headings (LCSH): | Cardiac arrest , Cardiac arrest -- Patients -- Care, Cardiac resuscitation , Cardiac intensive care | ||||||||
Journal or Publication Title: | European Heart Journal. Acute Cardiovascular Care | ||||||||
Publisher: | Oxford University Press | ||||||||
ISSN: | 2048-8734 | ||||||||
Official Date: | February 2023 | ||||||||
Dates: |
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Volume: | 12 | ||||||||
Number: | 2 | ||||||||
Page Range: | pp. 96-105 | ||||||||
DOI: | 10.1093/ehjacc/zuac153 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Re-use Statement: | This is a pre-copyedited, author-produced version of an article accepted for publication in European Heart Journal – Acute CardioVascular Care following peer review. The version of record - Pablo Jorge-Perez, Nikolaos Nikolaou, Katia Donadello, Abdo Khoury, Wilhelm Behringer, Christian Hassager, Bernd Boettiger, Alessandro Sionis, Jerry Nolan, Alain Combes, Tom Quinn, Susanna Price, Johannes Grand, Management of comatose survivors of out-of-hospital cardiac arrest in Europe: current treatment practice and adherence to guidelines. A joint survey by the Association for Acute CardioVascular Care (ACVC) of the ESC, the European Resuscitation Council (ERC), the European Society for Emergency Medicine (EUSEM), and the European Society of Intensive Care Medicine (ESICM), European Heart Journal. Acute Cardiovascular Care, Volume 12, Issue 2, February 2023, Pages 96–105 is available online at: https://doi.org/10.1093/ehjacc/zuac153 | ||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||
Date of first compliant deposit: | 24 February 2023 | ||||||||
Date of first compliant Open Access: | 2 December 2023 | ||||||||
RIOXX Funder/Project Grant: |
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