title: A survey on general and temperature management of post cardiac arrest patients in large teaching and university hospitals in 14 European countries-The SPAME trial results.
abstract: International guidelines recommend a bundle of care, including targeted temperature management (TTM), in post cardiac arrest survivors. Aside from a few small surveys in different European countries, adherence to the European Resuscitation Council (ERC) and European Society of Intensive Care Medicine (ESICM) recommendations are unknown.
  
  
  
  This international European telephone survey was conducted to provide an overview of current clinical practice of post cardiac arrest management with a main focus on TTM. We targeted large teaching and university hospitals within Europe as leading facilities and key opinion leaders in the field of post cardiac arrest care. Selected national principal investigators conducted the survey, which was based on a predefined questionnaire, between December 2014 and March 2015, before the publication of the ERC Guidelines 2015.
  
  
  
  The return rate was 94% from 268 participating intensive care units (ICU). The majority had a predefined standard operating procedure (SOP) protocol for post cardiac arrest patients. Altogether, 68% of the ICUs provided TTM at a target temperature of 32-34°C for 24h, and 33% had changed the target temperature to 36°C. The minority provided a written SOP for neurological prognostication, which was generally initiated 72h after return of spontaneous circulation (ROSC). Electroencephalography and somatosensory evoked potentials were used by most ICUs for early prognostication. Treating more than fifty patients a year was significantly associated with providing written SOPs for TTM and prognostication (p<0.01), as well as the use of a computer feedback device (p=0.03) for TTM.
  
  
  
  This international European telephone survey revealed a high rate of implementation of TTM in post cardiac arrest patients in university and teaching hospitals. Most participants also provided a SOP, but only a minority had a SOP for neurological prognostication.
authors.affiliation: Charité-Universitätsmedizin Berlin, Germany. Electronic address: christian.storm@charite.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Storm
authors.affiliation: Charité-Universitätsmedizin Berlin, Germany. Electronic address: jens.nee@charite.de.
authors.forename: J
authors.initials: J
authors.lastname: Nee
authors.affiliation: Dept. of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Norway. Electronic address: kjetil.sunde@medisin.uio.no.
authors.forename: Kjetil
authors.initials: K
authors.lastname: Sunde
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria. Electronic address: michael.holzer@meduniwien.ac.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Holzer
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria. Electronic address: pia.hubner@meduniwien.ac.at.
authors.forename: Pia
authors.initials: P
authors.lastname: Hubner
authors.affiliation: Dept. of Intensive Care, Erasme Hospital-Université Libre de Bruxelles (ULB) Brussels, Belgium. Electronic address: ftaccone@ulb.ac.be.
authors.forename: Fabio Silvio
authors.initials: FS
authors.lastname: Taccone
authors.affiliation: Dept. of Anesthesiology and Intensive Care Medicine, Skåne University Hospital, Lund University, Lund, Sweden. Electronic address: hans.a.friberg@gmail.com.
authors.forename: Hans
authors.initials: H
authors.lastname: Friberg
authors.affiliation: Dept. of Cardiology, La Paz-Idipaz University Hospital Madrid, Spain. Electronic address: e.lopezdesa@terra.com.
authors.forename: Esteban
authors.initials: E
authors.lastname: Lopez-de-Sa
authors.affiliation: Medical Intensive Care Unit, Cochin Hospital (Assistance Publique Hôpitaux de Paris)-INSERM U970 (Team 4) and Paris Descartes University, France. Electronic address: alain.cariou.perso@gmail.com.
authors.forename: Alain
authors.initials: A
authors.lastname: Cariou
authors.affiliation: Dept. of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: joerg.schefold@insel.ch.
authors.forename: Joerg C
authors.initials: JC
authors.lastname: Schefold
authors.affiliation: Dept. of Cardiovascular Research, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milan Italy and Italian Resuscitation Council, Bologna, Italy. Electronic address: gristag@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ristagno
authors.affiliation: Centre of Intensive Internal Medicine, University Medical Centre, Ljubljana, Slovenia. Electronic address: marko.noc@mf.uni-lj.si.
authors.forename: Marko
authors.initials: M
authors.lastname: Noc
authors.affiliation: Dept. of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: dirkdonker@ymail.com.
authors.forename: Dirk W
authors.initials: DW
authors.lastname: Donker
authors.affiliation: Dept. of Anaesthesiology and Intensive Care, Jagiellonian University Medical College Cracow, Poland. Electronic address: janusz.andres@uj.edu.pl.
authors.forename: Janusz
authors.initials: J
authors.lastname: Andres
authors.affiliation: Dept. of Anaesthesiology and Intensive Care, Jagiellonian University Medical College Cracow, Poland. Electronic address: p.krawczyk@uj.edu.pl.
authors.forename: Pawel
authors.initials: P
authors.lastname: Krawczyk
authors.affiliation: Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Division of Intensive Care, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital, Finland. Electronic address: Markus.Skrifvars@hus.fi.
authors.forename: Markus B
authors.initials: MB
authors.lastname: Skrifvars
authors.affiliation: Dept. of Anaesthesia and Intensive Care Medicine, Royal United Hospital Bath, UK. Electronic address: jpenketh@nhs.net.
authors.forename: James
authors.initials: J
authors.lastname: Penketh
authors.affiliation: Charité-Universitätsmedizin Berlin, Germany. Electronic address: alexander.krannich@biostats.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: Krannich
authors.affiliation: Dept. of Anaesthesiology and Intensive Care Medicine, St. Vincenz-Hospital, Limburg, Germany, Germany. Electronic address: m.fries@st-vincenz.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Fries
mesh_terms: D016887:Cardiopulmonary Resuscitation; D004569:Electroencephalography; D005060:Europe; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*
keywords: European survey; Post-resuscitation care; Standard operating procedure; Target temperature management