Intravascular Targeted Temperature Management: One Hospital's Experience.

Area of Science:

• Cardiology
• Critical Care Medicine
• Health Services Research

Background:

• Sudden cardiac arrest (SCA) is a major global cause of mortality.
• International guidelines recommend therapeutic hypothermia within 4 hours of return of spontaneous circulation (ROSC) for unresponsive patients.
• A Midwestern tertiary hospital struggled to meet these therapeutic hypothermia timing recommendations.

Purpose of the Study:

• To evaluate the effectiveness of an intravascular targeted temperature management (ITTM) system in reducing therapeutic hypothermia delays.
• To assess the implementation of ITTM within a hospital setting following a root cause analysis of therapy delays.

Main Methods:

• A 6-month trial of an ITTM system was conducted, guided by Donabedian's model.
• The trial included patients experiencing SCA with ROSC who remained unresponsive.
• Interprofessional education, updated policies, and new initiation processes were implemented alongside the ITTM system.

Main Results:

• The average time to reach target temperature decreased from 8.81 hours before the trial to 3.28 hours during the trial.
• Nine patients were included in the trial, demonstrating successful implementation of the ITTM system.
• The ITTM system facilitated meeting international therapeutic hypothermia recommendations.

Conclusions:

• The ITTM system is effective in significantly reducing treatment delays for post-SCA patients.
• Implementation of intravascular cooling can help hospitals achieve international survival recommendations.
• Reduced treatment delays hold promise for improving outcomes in the post-SCA population.