Practice Patterns and Trends in Temperature Control After Cardiac Arrest: A Multi-Specialty Survey

Area of Science:

• Critical Care Medicine
• Neurology
• Emergency Medicine

Background:

• Temperature control is recommended post-cardiac arrest, but practice variability persists.
• Conflicting evidence and trial interpretations contribute to inconsistent bedside implementation.
• Understanding physician perspectives is crucial for aligning care with evolving evidence.

Purpose of the Study:

• To assess international physician perceptions of temperature control after cardiac arrest.
• To characterize patterns of use, understanding of neurologic injury, and influence of new literature.
• To identify factors influencing temperature target selection and practice.

Main Methods:

• A 39-item web-based survey was distributed to critical care, neurology, and emergency medicine physicians.
• The survey assessed demographics, temperature control practices, and interpretation of recent trials.
• Responses from 471 physicians were analyzed using descriptive statistics.

Main Results:

• Targeted temperature management (TTM) was often initiated based on guidelines and institutional protocols.
• The most common temperature target was 36°C; awareness of the TTM2 trial was high, but practice changes were limited.
• Physician specialty, cardiac arrest volume, and practice setting influenced temperature target selection.

Conclusions:

• Significant heterogeneity exists in post-cardiac arrest temperature control practices and rationales.
• Institutional protocols heavily influence implementation, often overriding emerging evidence.
• Standardized, evidence-based pathways are recommended to reduce variability and improve care consistency.