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ERC-ESICM guidelines on temperature control after cardiac arrest in adults

Sandroni, Claudio ; Nolan, Jerry P. ; Andersen, Lars W. ; Böttiger, Bernd W. ; Cariou, Alain ; Cronberg, Tobias LU ; Friberg, Hans LU ; Genbrugge, Cornelia ; Lilja, Gisela LU and Morley, Peter T. , et al. (2022) In Intensive Care Medicine 48(3). p.261-269
Abstract

The aim of these guidelines is to provide evidence‑based guidance for temperature control in adults who are comatose after resuscitation from either in-hospital or out-of-hospital cardiac arrest, regardless of the underlying cardiac rhythm. These guidelines replace the recommendations on temperature management after cardiac arrest included in the 2021 post-resuscitation care guidelines co-issued by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). The guideline panel included thirteen international clinical experts who authored the 2021 ERC-ESICM guidelines and two methodologists who participated in the evidence review completed on behalf of the International Liaison Committee on... (More)

The aim of these guidelines is to provide evidence‑based guidance for temperature control in adults who are comatose after resuscitation from either in-hospital or out-of-hospital cardiac arrest, regardless of the underlying cardiac rhythm. These guidelines replace the recommendations on temperature management after cardiac arrest included in the 2021 post-resuscitation care guidelines co-issued by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). The guideline panel included thirteen international clinical experts who authored the 2021 ERC-ESICM guidelines and two methodologists who participated in the evidence review completed on behalf of the International Liaison Committee on Resuscitation (ILCOR) of whom ERC is a member society. We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence and grade recommendations. The panel provided suggestions on guideline implementation and identified priorities for future research. The certainty of evidence ranged from moderate to low. In patients who remain comatose after cardiac arrest, we recommend continuous monitoring of core temperature and actively preventing fever (defined as a temperature > 37.7 °C) for at least 72 h. There was insufficient evidence to recommend for or against temperature control at 32–36 °C or early cooling after cardiac arrest. We recommend not actively rewarming comatose patients with mild hypothermia after return of spontaneous circulation (ROSC) to achieve normothermia. We recommend not using prehospital cooling with rapid infusion of large volumes of cold intravenous fluids immediately after ROSC.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac arrest, Coma, Hypothermia, Practice guidelines, Prognosis
in
Intensive Care Medicine
volume
48
issue
3
pages
9 pages
publisher
Springer
external identifiers
  • pmid:35089409
  • scopus:85123837473
ISSN
0342-4642
DOI
10.1007/s00134-022-06620-5
language
English
LU publication?
yes
id
f7891bc2-94ad-4107-baeb-3fad22bfffd1
date added to LUP
2022-04-11 14:12:45
date last changed
2024-06-29 11:26:37
@article{f7891bc2-94ad-4107-baeb-3fad22bfffd1,
  abstract     = {{<p>The aim of these guidelines is to provide evidence‑based guidance for temperature control in adults who are comatose after resuscitation from either in-hospital or out-of-hospital cardiac arrest, regardless of the underlying cardiac rhythm. These guidelines replace the recommendations on temperature management after cardiac arrest included in the 2021 post-resuscitation care guidelines co-issued by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). The guideline panel included thirteen international clinical experts who authored the 2021 ERC-ESICM guidelines and two methodologists who participated in the evidence review completed on behalf of the International Liaison Committee on Resuscitation (ILCOR) of whom ERC is a member society. We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence and grade recommendations. The panel provided suggestions on guideline implementation and identified priorities for future research. The certainty of evidence ranged from moderate to low. In patients who remain comatose after cardiac arrest, we recommend continuous monitoring of core temperature and actively preventing fever (defined as a temperature &gt; 37.7 °C) for at least 72 h. There was insufficient evidence to recommend for or against temperature control at 32–36 °C or early cooling after cardiac arrest. We recommend not actively rewarming comatose patients with mild hypothermia after return of spontaneous circulation (ROSC) to achieve normothermia. We recommend not using prehospital cooling with rapid infusion of large volumes of cold intravenous fluids immediately after ROSC.</p>}},
  author       = {{Sandroni, Claudio and Nolan, Jerry P. and Andersen, Lars W. and Böttiger, Bernd W. and Cariou, Alain and Cronberg, Tobias and Friberg, Hans and Genbrugge, Cornelia and Lilja, Gisela and Morley, Peter T. and Nikolaou, Nikolaos and Olasveengen, Theresa M. and Skrifvars, Markus B. and Taccone, Fabio S. and Soar, Jasmeet}},
  issn         = {{0342-4642}},
  keywords     = {{Cardiac arrest; Coma; Hypothermia; Practice guidelines; Prognosis}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{261--269}},
  publisher    = {{Springer}},
  series       = {{Intensive Care Medicine}},
  title        = {{ERC-ESICM guidelines on temperature control after cardiac arrest in adults}},
  url          = {{http://dx.doi.org/10.1007/s00134-022-06620-5}},
  doi          = {{10.1007/s00134-022-06620-5}},
  volume       = {{48}},
  year         = {{2022}},
}