Practice Patterns after the Therapeutic Hypothermia After Pediatric Cardiac Arrest Out-of-Hospital Trial: A Survey of Pediatric Critical Care Physicians

Marianne R Gildea; Frank W Moler; Kent Page; Victoria L Pemberton; Richard Holubkov; Vinay M Nadkarni; J Michael Dean; Lenora M Olson

doi:10.1055/s-0038-1667380

Practice Patterns after the Therapeutic Hypothermia After Pediatric Cardiac Arrest Out-of-Hospital Trial: A Survey of Pediatric Critical Care Physicians

J Pediatr Intensive Care. 2019 Jun;8(2):71-77. doi: 10.1055/s-0038-1667380. Epub 2018 Aug 12.

Authors

Marianne R Gildea¹, Frank W Moler², Kent Page¹, Victoria L Pemberton³, Richard Holubkov¹, Vinay M Nadkarni⁴, J Michael Dean¹, Lenora M Olson¹

Affiliations

¹ Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States.
² Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, United States.
³ National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States.
⁴ Department of Anesthesiology and Critical Care Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States.

Abstract

The Therapeutic Hypothermia After Pediatric Cardiac Arrest Out-of-Hospital (THAPCA-OH) Trial showed therapeutic hypothermia, versus normothermia, did not significantly improve 1-year survival with good neurobehavioral outcome. Our survey of pediatric critical care physicians, designed to assess the use of targeted temperature management (TTM) after publication of the main THAPCA-OH Trial results, found most respondents were aware of trial results, and over 90% agreed THAPCA-OH was well-designed with important clinical outcomes. While most respondents reported TTM usage consistent with THAPCA-OH results in different patient scenarios, 15% did not select TTM for fever management. Since trials prior to THAPCA-OH established that fever is harmful following brain injury, the continued incomplete adoption of TTM warrants further research on challenges and facilitators to the adoption of clinical trial findings.

Keywords: THAPCA-OH; survey; targeted temperature management.