Induced hypothermia is underused after resuscitation from cardiac arrest: a current practice survey.
BACKGROUND
Important recent work has demonstrated that the use of induced hypothermia can improve survival and neurologic recovery after cardiac arrest. We wished to ascertain the extent to which physicians were using this treatment, and what opinions are held by clinicians regarding its use.


METHODS
An internet-based survey of physicians was conducted, with physicians chosen at random from published directories of the Society for Academic Emergency Medicine, the American Thoracic Society, and the American Heart Association. Physicians were questioned regarding use of therapeutic hypothermia, methods employed, and/or reasons why they had not incorporated hypothermia into their care of cardiac arrest patients.


RESULTS
Completed surveys were collected from 265 physicians, including those practicing emergency medicine (41%), critical care (13%), and cardiology (24%). Respondents were geographically well distributed and the majority (94%) were at post-training level. Most respondents (78%) practiced at either larger referral hospitals or academic medical centers. When asked if they had ever used hypothermia following cardiac arrest, 87% said they had not. Among reasons cited for non-use, 49% felt that there were not enough data, 32% mentioned lack of incorporation of hypothermia into advanced cardiovascular life support (ACLS) protocols, and 28% felt that cooling methods were technically too difficult or too slow.


CONCLUSIONS
Despite compelling data supporting its use, hypothermia has yet to be broadly incorporated into physician practice. This highlights the need for improved awareness and education regarding this treatment option, as well as the need to consider hypothermia protocols for inclusion in future iterations of ACLS.
Abella
Benjamin S
BS
Emergency Resuscitation Center, Section of Emergency Medicine, University of Chicago Hospitals, 5841 S. Maryland Avenue, MC 5068 Chicago, IL 60637, USA. babella@medicine.bsd.uchicago.edu
Rhee
James W
JW
Huang
Kuang-Ning
KN
Vanden Hoek
Terry L
TL
Becker
Lance B
LB
D001291:Attitude of Health Personnel; D002309:Cardiology / Q000706:statistics & numerical data; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000706:statistics & numerical data*; D003422:Critical Care / Q000706:statistics & numerical data; D004635:Emergency Medicine / Q000706:statistics & numerical data; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods / Q000706:statistics & numerical data*; D014481:United States