Abstract

Background Targeted temperature management (TTM) improves outcomes in patients with Out-of-Hospital cardiac arrest (OHCA) due to Shockable rhythms. The frequency with which TTM is used for Non-Shockable cardiac arrest rhythms and for In-Hospital cardiac arrest (IHCA) is unknown. Methods Within the prospective multicenter Penn Alliance for Therapeutic Hypothermia registry we examined the proportion of patients treated with TTM for OHCA vs. IHCA, and for Shockable vs. Non-Shockable cardiac arrest rhythms. Results Of 976 patients treated with TTM, 785 (80.4%) were for OHCA, with a trend (P for trend of 0.05) for a higher proportion of cardiac arrests due to OHCA over time. Most (523 [56.8%]) of those treated with TTM had Non-Shockable cardiac arrest rhythms. Notably, TTM was initiated for OHCA due to a Shockable cardiac arrest rhythm in only 349 (37.9%) patients, although the proportion has increased over time (30.6% in 2010; 45.2% in 2014; P for trend of 0.04). Conclusion In real-world practice, only 2 in 5 cardiac arrest patients treated with TTM are for OHCA due to a Shockable rhythm. Given uncertain observational study results for TTM for IHCA and Non-Shockable cardiac arrest rhythms, there remains a need for prospective trials of TTM for these other treatment indications.

Authors and Affiliations