title: Variability in Postarrest Targeted Temperature Management Practice: Implications of the 2015 Guidelines.
abstract: In 2002 postarrest care was significantly altered when multiple randomized controlled trials found that therapeutic hypothermia at a goal temperature of 32-34°C significantly improved survival and neurologic outcomes. In 2013, targeted temperature management (TTM) was reexamined via a randomized controlled trial between 33°C and 36°C in post-cardiac arrest patients and found similar outcomes in both cohorts. Before the release of the 2015 American Heart Association (AHA) Guidelines, our group found that across hospitals in the United States, and even within the same institution, TTM protocol variability existed. After the 2013 TTM trial, it was anticipated that the 2015 Guidelines would clarify which target temperature should be used during postarrest care. The AHA released their updates for post-cardiac arrest TTM recently and, based on the literature available, have recommended the use of TTM at a goal temperature between 32°C and 36°C. Whether this variability has an effect on TTM implementation or patient outcomes is unknown.
authors.affiliation: 1 Department of Emergency Medicine, Center for Resuscitation Science, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania.|2 School of Nursing, University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Marion
authors.initials: M
authors.lastname: Leary
authors.affiliation: 1 Department of Emergency Medicine, Center for Resuscitation Science, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania.|3 Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania.
authors.forename: Audrey L
authors.initials: AL
authors.lastname: Blewer
authors.affiliation: 1 Department of Emergency Medicine, Center for Resuscitation Science, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania.
authors.forename: Gail
authors.initials: G
authors.lastname: Delfin
authors.affiliation: 1 Department of Emergency Medicine, Center for Resuscitation Science, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania.|4 Section of Pulmonary Allergy and Critical Care, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania.
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Abella
mesh_terms: D000572:American Heart Association; D001833:Body Temperature Regulation; D019983:Guideline Adherence / Q000592:standards; D006323:Heart Arrest / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000592:standards*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D012151:Resuscitation / Q000592:standards*; D016896:Treatment Outcome; D014481:United States