Post resuscitation care of out-of-hospital cardiac arrest patients in the Nordic countries: A questionnaire study

Abstract

Background: Aim of this study was to compare post resuscitation care of out-of-hospital cardiac arrest (OHCA) patients in Nordic (Denmark, Finland, Iceland, Norway, Sweden) intensive care units (ICUs). Methods: An online questionnaire was sent to Nordic ICUs in 2012 and was complemented by an additional one in 2014. Results: The first questionnaire was sent to 188 and the second one to 184 ICUs. Response rates were 51% and 46%. In 2012, 37% of the ICUs treated all patients resuscitated from OHCA with targeted temperature management (TTM) at 33°C. All OHCA patients admitted to the ICU were treated with TTM at 33°C more often in Norway (69%) compared to Finland (20%) and Sweden (25%), p 0.02 and 0.014. In 2014, 63% of the ICUs still use TTM at 33°C, but 33% use TTM at 36°C. Early coronary angiography (CAG) and possible percutaneous coronary intervention (PCI) was routinely provided for all survivors of OHCA in 39% of the hospitals in 2012 and in 28% of the hospitals in 2014. Routine CAG for all actively treated victims of OHCA was performed more frequently in Sweden (51%) and in Norway (54%) compared to Finland (13%), p 0.014 and 0.042. Conclusions: Since 2012, TTM at 36°C has been implemented in some ICUs, but TTM at 33°C is used in majority of the ICUs. TTM at 33 or 36°C and primary CAG are not routinely provided for all OHCA survivors and the criteria for these and ICU admission are variable. Best practices as a uniform approach to the optimal care of the resuscitated patient should be sought in the Nordic Countries.