Abstract

BackgroundAim of this study was to compare post resuscitation care of out-of-hospital cardiac arrest (OHCA) patients in Nordic (Denmark, Finland, Iceland, Norway, Sweden) intensive care units (ICUs).MethodsAn online questionnaire was sent to Nordic ICUs in 2012 and was complemented by an additional one in 2014.ResultsThe first questionnaire was sent to 188 and the second one to 184 ICUs. Response rates were 51 % and 46 %. In 2012, 37 % of the ICUs treated all patients resuscitated from OHCA with targeted temperature management (TTM) at 33 °C. All OHCA patients admitted to the ICU were treated with TTM at 33 °C more often in Norway (69 %) compared to Finland (20 %) and Sweden (25 %), p 0.02 and 0.014. In 2014, 63 % of the ICUs still use TTM at 33 °C, but 33 % use TTM at 36 °C. Early coronary angiography (CAG) and possible percutaneous coronary intervention (PCI) was routinely provided for all survivors of OHCA in 39 % of the hospitals in 2012 and in 28 % of the hospitals in 2014. Routine CAG for all actively treated victims of OHCA was performed more frequently in Sweden (51 %) and in Norway (54 %) compared to Finland (13 %), p 0.014 and 0.042.ConclusionsSince 2012, TTM at 36 °C has been implemented in some ICUs, but TTM at 33 °C is used in majority of the ICUs. TTM at 33 or 36 °C and primary CAG are not routinely provided for all OHCA survivors and the criteria for these and ICU admission are variable. Best practices as a uniform approach to the optimal care of the resuscitated patient should be sought in the Nordic Countries.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-015-0141-z) contains supplementary material, which is available to authorized users.

Highlights

  • Aim of this study was to compare post resuscitation care of out-of-hospital cardiac arrest (OHCA) patients in Nordic (Denmark, Finland, Iceland, Norway, Sweden) intensive care units (ICUs)

  • These dismal figures persist despite advances in resuscitation medicine- some centers have been able to increase survival using a goal-directed post resuscitation protocol including early routine coronary angiography (CAG) with possible percutaneous coronary intervention (PCI) and targeted temperature management at 33 °C [3]

  • On a national level in clinical work, we have observed that hospital policies and criteria for intensive care unit (ICU) admission of OHCA survivors vary, as well as treatment modalities provided, which might affect survival

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Summary

Introduction

Aim of this study was to compare post resuscitation care of out-of-hospital cardiac arrest (OHCA) patients in Nordic (Denmark, Finland, Iceland, Norway, Sweden) intensive care units (ICUs). International guidelines are set to guide the treatment of cardiac arrest victims, it is likely that hospital policies regarding post resuscitation treatment vary. This may be a reflection of the inconclusive nature of scientific evidence upon the optimal. No comparison of provided post resuscitation care between the ICUs in the Nordic countries (Denmark, Finland, Iceland, Norway, Sweden) has been done With this survey, our aim was to investigate ICU treatment and possible differences in the treatment of OHCA patients in the Nordic countries

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