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Ther Hypothermia Temp Manag. 2017 Mar;7(1):30-35. doi: 10.1089/ther.2016.0017. Epub 2016 Jul 15.

Variability of Post-Cardiac Arrest Care Practices Among Cardiac Arrest Centers: United States and South Korean Dual Network Survey of Emergency Physician Research Principal Investigators.

Author information

1
1 Department of Emergency Medicine, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
2
2 Department of Physician Assistant Studies, University of the Sciences , Philadelphia, Pennsylvania.
3
3 Department of Emergency Medicine, William Beaumont Hospital , Royal Oak, Michigan.
4
4 Department of Emergency Medicine, The Catholic University of Korea , Seoul, South Korea .
5
5 Department of Emergency Medicine, Michigan State University College of Human Medicine , Grand Rapids, Michigan.
6
6 Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University Hospital , Philadelphia, Pennsylvania.
7
7 Chonnam National University Hospital , Gwangju, South Korea .
8
8 Ulsan University College of Medicine , Asan Medical Center, Seoul, South Korea .
9
9 Soonchunhyang University Cheonan Hospital , Cheonan, South Korea .
10
10 Department of Emergency Medicine, Pereleman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
11
11 Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Abstract

There is little consensus regarding many post-cardiac arrest care parameters. Variability in such practices could confound the results and generalizability of post-arrest care research. We sought to characterize the variability in post-cardiac arrest care practice in Korea and the United States. A 54-question survey was sent to investigators participating in one of two research groups in South Korea (Korean Hypothermia Network [KORHN]) and the United States (National Post-Arrest Research Consortium [NPARC]). Single investigators from each site were surveyed (N = 40). Participants answered questions based on local institutional protocols and practice. We calculated descriptive statistics for all variables. Forty surveys were completed during the study period with 30 having greater than 50% of questions completed (75% response rate; 24 KORHN and 6 NPARC). Most centers target either 33°C (N = 16) or vary the target based on patient characteristics (N = 13). Both bolus and continuous infusion dosing of sedation are employed. No single indication was unanimous for cardiac catheterization. Only six investigators reported having an institutional protocol for withdrawal of life-sustaining therapy (WLST). US patients with poor neurological prognosis tended to have WLST with subsequent expiration (N = 5), whereas Korean patients are transferred to a secondary care facility (N = 19). Both electroencephalography modality and duration vary between institutions. Serum biomarkers are commonly employed by Korean, but not US centers. We found significant variability in post-cardiac arrest care practices among US and Korean medical centers. These practice variations must be taken into account in future studies of post-arrest care.

KEYWORDS:

cardiac arrest; critical care neuroprognostication; targeted temperature management; therapeutic hypothermia; withdrawal of life-sustaining therapies

PMID:
27419613
PMCID:
PMC6913787
DOI:
10.1089/ther.2016.0017
[Indexed for MEDLINE]
Free PMC Article

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