Clinical application status of target temperature management for cardiac arrest patients in domestic and international medical institutions_West China Medical Journal

Authors：

ZHU Wei ¹ , LIU Ruihong ¹ , YANG Xinsheng ² , XIE Lei ³ ,  HE Bosheng ⁴

1. Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Nantong University / Nantong First People’s Hospital, Nantong, Jiangsu 226000, P. R. China;
2. Department of Ophthalmology, Nantong Wen Ci Eye Hospital, Nantong, Jiangsu 226000, P. R. China;
3. Department of Reproductive Medicine, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200120, P. R. China;
4. Center for Translational Medicine Research, the Second Affiliated Hospital of Nantong University / Nantong First People’s Hospital, Nantong, Jiangsu 226000, P. R. China;

Corresponding author：

HE Bosheng, Email: 15906290998@163.com

Keywords：

Medical institutions; cardiac arrest; target temperature management

DOI：

10.7507/1002-0179.202408024

Video：

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In recent years, target temperature management (TTM) has been increasingly applied to cardiac arrest patients, and programs and strategies for TTM are in a constant state of update and refinement. This paper analyzes and proposes relevant strategies from the concept of TTM, its clinical application status for cardiac arrest patients in domestic and international medical institutions, its deficiencies in the clinical practice, and factors affecting the development of TTM, with a view to providing a realistic basis for the development of high-quality TTM in medical institutions.

1.	Ma Q, Feng L, Wang T, et al. 2020 expert consensus statement on neuro-protection after cardiac arrest in China. Ann Transl Med, 2021, 9(2): 175.
2.	Schenone AL, Cohen A, Patarroyo G, et al. Therapeutic hypothermia after cardiac arrest: a systematic review/meta-analysis exploring the impact of expanded criteria and targeted temperature. Resuscitation, 2016, 108: 102-110.
3.	Callaway CW, Donnino MW, Fink EL, et al. Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 2015, 132(18 Suppl 2): S465-S482.
4.	Roedl K, Wolfrum S, Michels G, et al. Temperature control in adults after cardiac arrest: a survey of current clinical practice in Germany. Crit Care, 2023, 27(1): 35.
5.	de Longeaux K, Bailly P. Post-resuscitation care following cardiac arrest in intensive care units: a French national survey. Resuscitation, 2023, 184: 109701.
6.	Fordyce CB, Chen AY, Wang TY, et al. Patterns of use of targeted temperature management for acute myocardial infarction patients following out-of-hospital cardiac arrest: insights from the National Cardiovascular Data Registry. Am Heart J, 2018, 206: 131-133.
7.	梁大炼, 陈嘉萍, 张秀浓. 广东省临床护士对心脏骤停复苏后患者目标体温管理现状调查及分析. 中外医学研究, 2020, 18(34): 88-91.
8.	马莉, 杜兰芳, 马青变, 等. 北京市护理人员对心脏骤停患者目标体温管理的现状调查. 中华护理杂志, 2019, 54(9): 1373-1378.
9.	Karnatovskaia LV, Wartenberg KE, Freeman WD. Therapeutic hypothermia for neuroprotection: history, mechanisms, risks, and clinical applications. Neurohospitalist, 2014, 4(3): 153-163.
10.	中国医师协会急诊医师分会, 中国医药教育协会急诊医学专业委员会, 成人急危重症脑损伤患者目标温度管理临床实践专家共识组. 成人急危重症脑损伤患者目标温度管理临床实践专家共识. 中华急诊医学杂志, 2019, 28(3): 282-291.
11.	Skulec R, Truhlár A, Knor J, et al. The practice of therapeutic mild hypothermia in cardiac arrest survivors in the Czech republic. Minerva Anestesiol, 2010, 76(8): 617-623.
12.	Rao MP, Dupre ME, Pokorney SD, et al. Therapeutic hypothermia for patients with out-of-hospital cardiac arrest in North Carolina. Prehosp Emerg Care, 2016, 20(5): 630-636.
13.	Nunnally ME, Jaeschke R, Bellingan GJ, et al. Targeted temperature management in critical care: a report and recommendations from five professional societies. Crit Care Med, 2011, 39(5): 1113-1125.
14.	Sheila AA, 高雯. 目标体温管理在脑保护中的应用研究进展. 中华急危重症护理杂志, 2020, 1(5): 468-474.
15.	Morrison LJ, Thoma B. Translating targeted temperature management trials into postarrest care. N Engl J Med, 2021, 384(24): 2344-2345.
16.	Gräsner JT, Herlitz J, Tjelmeland IBM, et al. European Resuscitation Council Guidelines 2021: epidemiology of cardiac arrest in Europe. Resuscitation, 2021, 161: 61-79.
17.	Cariou A, Payen JF, Asehnoune K, et al. Targeted temperature management in the ICU: guidelines from a French expert panel. Ann Intensive Care, 2017, 7(1): 70.
18.	Howes D, Gray SH, Brooks SC, et al. Canadian Guidelines for the use of targeted temperature management (therapeutic hypothermia) after cardiac arrest: a joint statement from The Canadian Critical Care Society (CCCS), Canadian Neurocritical Care Society (CNCCS), and the Canadian Critical Care Trials Group (CCCTG). Resuscitation, 2016, 98: 48-63.
19.	Nolan JP, Sandroni C, Andersen LW, et al. ERC-ESICM guidelines on temperature control after cardiac arrest in adults. Resuscitation, 2022, 172: 229-236.
20.	中国研究型医院学会神经再生与修复专业委员会心脏重症脑保护学组, 中国研究型医院学会神经再生与修复专业委员会神经重症护理与康复学组. 亚低温脑保护中国专家共识. 中华危重病急救医学, 2020, 32(4): 385-391.
21.	Nielsen N, Wetterslev J, Cronberg T, et al. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med, 2013, 369(23): 2197-2206.
22.	Hermel M, Bosson N, Fang A, et al. Implementation of targeted temperature management after out-of-hospital cardiac arrest: observations from the Los Angeles County Regional System. J Am Heart Assoc, 2020, 9(24): e016652.
23.	Jorge-Perez P, Nikolaou N, Donadello K, et al. 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). Eur Heart J Acute Cardiovasc Care, 2023, 12(2): 96-105.
24.	Järpestam S, Martinell L, Rylander C, et al. Post-cardiac arrest intensive care in Sweden: a survey of current clinical practice. Acta Anaesthesiol Scand, 2023, 67(9): 1249-1255.
25.	Bray JE, Cartledge S, Finn J, et al. The current temperature: a survey of post-resuscitation care across Australian and New Zealand intensive care units. Resusc Plus, 2020, 1-2: 100002.
26.	Madden LK, Hill M, May TL, et al. The implementation of targeted temperature management: an evidence-based guideline from the Neurocritical Care Society. Neurocrit Care, 2017, 27(3): 468-487.
27.	Kim SH, Park KN, Youn CS, et al. Outcome and status of postcardiac arrest care in Korea: results from the Korean Hypothermia Network prospective registry. Clin Exp Emerg Med, 2020, 7(4): 250-258.
28.	Hifumi T, Inoue A, Otani T, et al. Details of targeted temperature management methods for patients who had out-of-hospital cardiac arrest receiving extracorporeal cardiopulmonary resuscitation: a questionnaire survey. Ther Hypothermia Temp Manag, 2022, 12(4): 215-222.
29.	Cutuli SL, Osawa EA, Glassford NJ, et al. Body temperature measurement methods and targets in Australian and New Zealand intensive care units. Crit Care Resusc, 2018, 20(3): 241-244.
30.	Zhou SE, Barden MM, Gilmore EJ, et al. Postcardiac arrest neuroprognostication practices: a survey of Brazilian physicians. Crit Care Explor, 2021, 3(1): e0321.
31.	Bakhsh A, Alotaibi H, Alothman S, et al. Opinions and attitudes toward targeted temperature management in the emergency department and intensive care unit in a developing country: a survey study. World J Emerg Med, 2023, 14(2): 138-142.
32.	郑康, 杜兰芳, 李姝, 等. 北京大学第三医院心脏骤停后目标温度管理实施规范. 中国急救医学, 2021, 41(7): 588-592.
33.	杜兰芳, 郑康, 冯璐, 等. 中国急诊医生对心脏骤停后脑保护认知及实践现况调查. 中国急救医学, 2022, 42(10): 845-849.
34.	Du L, Ge B, Ma Q, et al. Changes in cardiac arrest patients’ temperature management after the publication of 2015 AHA guidelines for resuscitation in China. Sci Rep, 2017, 7(1): 16087.
35.	Krawczyk P, Kołodziej G, Szpyra B, et al. Implementation of therapeutic hypothermia after cardiac arrest in intensive care units in Poland. Kardiol Pol, 2013, 71(3): 270-274.
36.	Kołtowski L, Malesa K, Tomaniak M, et al. Implementation of mild therapeutic hypothermia for post-resuscitation care of sudden cardiac arrest survivors in cardiology units in Poland. Adv Clin Exp Med, 2017, 26(8): 1207-1212.
37.	Krawczyk P, Tarczyńska A, Dziadek G, et al. Implementation of targeted temperature management after cardiac arrest in Polish intensive care units. What has changed in the last five years?. Kardiol Pol, 2017, 75(7): 689-697.
38.	Wils EJ, van den Berg T, van Bommel J. Current practice of target temperature management post-cardiac arrest in the Netherlands, a post-TTM trial survey. Resuscitation, 2015, 96(Suppl 1): 124-125.
39.	Semeraro F, Greif R, Böttiger BW, et al. European Resuscitation Council Guidelines 2021: systems saving lives. Resuscitation, 2021, 161: 80-97.
40.	Sinning C, Ahrens I, Cariou A, et al. The cardiac arrest centre for the treatment of sudden cardiac arrest due to presumed cardiac cause - aims, function and structure: position paper of the Association for Acute CardioVascular Care of the European Society of Cardiology (AVCV), European Association of Percutaneous Coronary Interventions (EAPCI), European Heart Rhythm Association (EHRA), European Resuscitation Council (ERC), European Society for Emergency Medicine (EUSEM) and European Society of Intensive Care Medicine (ESICM). Eur Heart J Acute Cardiovasc Care, 2020, 9(4_Suppl): S193-S202.
41.	Yeo JW, Ng ZHC, Goh AXC, et al. Impact of cardiac arrest centers on the survival of patients with nontraumatic out-of-hospital cardiac arrest: a systematic review and meta-analysis. J Am Heart Assoc, 2022, 11(1): e023806.
42.	张茂, 陈玉国. 积极推进复苏中心建设, 加速急诊医学科发展. 中华急诊医学杂志, 2018, 27(1): 3-6.
43.	浙江省急诊医学质量控制中心, 浙江省院前医疗急救质量控制中心, 浙江省心血管疾病介入诊疗质控中心, 等. 复苏中心建设浙江共识. 中华急诊医学杂志, 2023, 32(4): 455-463.
44.	心脏骤停后目标温度管理共识专家组. 心脏骤停后目标温度管理专家共识. 中华急诊医学杂志, 2016, 25(8): 1000-1006.
45.	Al-Adsani AM, Moussa MA, Al-Jasem LI, et al. The level and determinants of diabetes knowledge in Kuwaiti adults with type 2 diabetes. Diabetes Metab, 2009, 35(2): 121-128.

1. Ma Q, Feng L, Wang T, et al. 2020 expert consensus statement on neuro-protection after cardiac arrest in China. Ann Transl Med, 2021, 9(2): 175.
2. Schenone AL, Cohen A, Patarroyo G, et al. Therapeutic hypothermia after cardiac arrest: a systematic review/meta-analysis exploring the impact of expanded criteria and targeted temperature. Resuscitation, 2016, 108: 102-110.
3. Callaway CW, Donnino MW, Fink EL, et al. Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 2015, 132(18 Suppl 2): S465-S482.
4. Roedl K, Wolfrum S, Michels G, et al. Temperature control in adults after cardiac arrest: a survey of current clinical practice in Germany. Crit Care, 2023, 27(1): 35.
5. de Longeaux K, Bailly P. Post-resuscitation care following cardiac arrest in intensive care units: a French national survey. Resuscitation, 2023, 184: 109701.
6. Fordyce CB, Chen AY, Wang TY, et al. Patterns of use of targeted temperature management for acute myocardial infarction patients following out-of-hospital cardiac arrest: insights from the National Cardiovascular Data Registry. Am Heart J, 2018, 206: 131-133.
7. 梁大炼, 陈嘉萍, 张秀浓. 广东省临床护士对心脏骤停复苏后患者目标体温管理现状调查及分析. 中外医学研究, 2020, 18(34): 88-91.
8. 马莉, 杜兰芳, 马青变, 等. 北京市护理人员对心脏骤停患者目标体温管理的现状调查. 中华护理杂志, 2019, 54(9): 1373-1378.
9. Karnatovskaia LV, Wartenberg KE, Freeman WD. Therapeutic hypothermia for neuroprotection: history, mechanisms, risks, and clinical applications. Neurohospitalist, 2014, 4(3): 153-163.
10. 中国医师协会急诊医师分会, 中国医药教育协会急诊医学专业委员会, 成人急危重症脑损伤患者目标温度管理临床实践专家共识组. 成人急危重症脑损伤患者目标温度管理临床实践专家共识. 中华急诊医学杂志, 2019, 28(3): 282-291.
11. Skulec R, Truhlár A, Knor J, et al. The practice of therapeutic mild hypothermia in cardiac arrest survivors in the Czech republic. Minerva Anestesiol, 2010, 76(8): 617-623.
12. Rao MP, Dupre ME, Pokorney SD, et al. Therapeutic hypothermia for patients with out-of-hospital cardiac arrest in North Carolina. Prehosp Emerg Care, 2016, 20(5): 630-636.
13. Nunnally ME, Jaeschke R, Bellingan GJ, et al. Targeted temperature management in critical care: a report and recommendations from five professional societies. Crit Care Med, 2011, 39(5): 1113-1125.
14. Sheila AA, 高雯. 目标体温管理在脑保护中的应用研究进展. 中华急危重症护理杂志, 2020, 1(5): 468-474.
15. Morrison LJ, Thoma B. Translating targeted temperature management trials into postarrest care. N Engl J Med, 2021, 384(24): 2344-2345.
16. Gräsner JT, Herlitz J, Tjelmeland IBM, et al. European Resuscitation Council Guidelines 2021: epidemiology of cardiac arrest in Europe. Resuscitation, 2021, 161: 61-79.
17. Cariou A, Payen JF, Asehnoune K, et al. Targeted temperature management in the ICU: guidelines from a French expert panel. Ann Intensive Care, 2017, 7(1): 70.
18. Howes D, Gray SH, Brooks SC, et al. Canadian Guidelines for the use of targeted temperature management (therapeutic hypothermia) after cardiac arrest: a joint statement from The Canadian Critical Care Society (CCCS), Canadian Neurocritical Care Society (CNCCS), and the Canadian Critical Care Trials Group (CCCTG). Resuscitation, 2016, 98: 48-63.
19. Nolan JP, Sandroni C, Andersen LW, et al. ERC-ESICM guidelines on temperature control after cardiac arrest in adults. Resuscitation, 2022, 172: 229-236.
20. 中国研究型医院学会神经再生与修复专业委员会心脏重症脑保护学组, 中国研究型医院学会神经再生与修复专业委员会神经重症护理与康复学组. 亚低温脑保护中国专家共识. 中华危重病急救医学, 2020, 32(4): 385-391.
21. Nielsen N, Wetterslev J, Cronberg T, et al. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med, 2013, 369(23): 2197-2206.
22. Hermel M, Bosson N, Fang A, et al. Implementation of targeted temperature management after out-of-hospital cardiac arrest: observations from the Los Angeles County Regional System. J Am Heart Assoc, 2020, 9(24): e016652.
23. Jorge-Perez P, Nikolaou N, Donadello K, et al. 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). Eur Heart J Acute Cardiovasc Care, 2023, 12(2): 96-105.
24. Järpestam S, Martinell L, Rylander C, et al. Post-cardiac arrest intensive care in Sweden: a survey of current clinical practice. Acta Anaesthesiol Scand, 2023, 67(9): 1249-1255.
25. Bray JE, Cartledge S, Finn J, et al. The current temperature: a survey of post-resuscitation care across Australian and New Zealand intensive care units. Resusc Plus, 2020, 1-2: 100002.
26. Madden LK, Hill M, May TL, et al. The implementation of targeted temperature management: an evidence-based guideline from the Neurocritical Care Society. Neurocrit Care, 2017, 27(3): 468-487.
27. Kim SH, Park KN, Youn CS, et al. Outcome and status of postcardiac arrest care in Korea: results from the Korean Hypothermia Network prospective registry. Clin Exp Emerg Med, 2020, 7(4): 250-258.
28. Hifumi T, Inoue A, Otani T, et al. Details of targeted temperature management methods for patients who had out-of-hospital cardiac arrest receiving extracorporeal cardiopulmonary resuscitation: a questionnaire survey. Ther Hypothermia Temp Manag, 2022, 12(4): 215-222.
29. Cutuli SL, Osawa EA, Glassford NJ, et al. Body temperature measurement methods and targets in Australian and New Zealand intensive care units. Crit Care Resusc, 2018, 20(3): 241-244.
30. Zhou SE, Barden MM, Gilmore EJ, et al. Postcardiac arrest neuroprognostication practices: a survey of Brazilian physicians. Crit Care Explor, 2021, 3(1): e0321.
31. Bakhsh A, Alotaibi H, Alothman S, et al. Opinions and attitudes toward targeted temperature management in the emergency department and intensive care unit in a developing country: a survey study. World J Emerg Med, 2023, 14(2): 138-142.
32. 郑康, 杜兰芳, 李姝, 等. 北京大学第三医院心脏骤停后目标温度管理实施规范. 中国急救医学, 2021, 41(7): 588-592.
33. 杜兰芳, 郑康, 冯璐, 等. 中国急诊医生对心脏骤停后脑保护认知及实践现况调查. 中国急救医学, 2022, 42(10): 845-849.
34. Du L, Ge B, Ma Q, et al. Changes in cardiac arrest patients’ temperature management after the publication of 2015 AHA guidelines for resuscitation in China. Sci Rep, 2017, 7(1): 16087.
35. Krawczyk P, Kołodziej G, Szpyra B, et al. Implementation of therapeutic hypothermia after cardiac arrest in intensive care units in Poland. Kardiol Pol, 2013, 71(3): 270-274.
36. Kołtowski L, Malesa K, Tomaniak M, et al. Implementation of mild therapeutic hypothermia for post-resuscitation care of sudden cardiac arrest survivors in cardiology units in Poland. Adv Clin Exp Med, 2017, 26(8): 1207-1212.
37. Krawczyk P, Tarczyńska A, Dziadek G, et al. Implementation of targeted temperature management after cardiac arrest in Polish intensive care units. What has changed in the last five years?. Kardiol Pol, 2017, 75(7): 689-697.
38. Wils EJ, van den Berg T, van Bommel J. Current practice of target temperature management post-cardiac arrest in the Netherlands, a post-TTM trial survey. Resuscitation, 2015, 96(Suppl 1): 124-125.
39. Semeraro F, Greif R, Böttiger BW, et al. European Resuscitation Council Guidelines 2021: systems saving lives. Resuscitation, 2021, 161: 80-97.
40. Sinning C, Ahrens I, Cariou A, et al. The cardiac arrest centre for the treatment of sudden cardiac arrest due to presumed cardiac cause - aims, function and structure: position paper of the Association for Acute CardioVascular Care of the European Society of Cardiology (AVCV), European Association of Percutaneous Coronary Interventions (EAPCI), European Heart Rhythm Association (EHRA), European Resuscitation Council (ERC), European Society for Emergency Medicine (EUSEM) and European Society of Intensive Care Medicine (ESICM). Eur Heart J Acute Cardiovasc Care, 2020, 9(4_Suppl): S193-S202.
41. Yeo JW, Ng ZHC, Goh AXC, et al. Impact of cardiac arrest centers on the survival of patients with nontraumatic out-of-hospital cardiac arrest: a systematic review and meta-analysis. J Am Heart Assoc, 2022, 11(1): e023806.
42. 张茂, 陈玉国. 积极推进复苏中心建设, 加速急诊医学科发展. 中华急诊医学杂志, 2018, 27(1): 3-6.
43. 浙江省急诊医学质量控制中心, 浙江省院前医疗急救质量控制中心, 浙江省心血管疾病介入诊疗质控中心, 等. 复苏中心建设浙江共识. 中华急诊医学杂志, 2023, 32(4): 455-463.
44. 心脏骤停后目标温度管理共识专家组. 心脏骤停后目标温度管理专家共识. 中华急诊医学杂志, 2016, 25(8): 1000-1006.
45. Al-Adsani AM, Moussa MA, Al-Jasem LI, et al. The level and determinants of diabetes knowledge in Kuwaiti adults with type 2 diabetes. Diabetes Metab, 2009, 35(2): 121-128.

West China Medical Journal

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