Use of a Standardized Order Set for Achieving Target Temperature in the Implementation of Therapeutic Hypothermia after Cardiac Arrest: A Feasibility Study

Kilgannon, J. Hope; Roberts, Brian W.; Stauss, Mary; Cimino, Mary Jo; Ferchau, Lynn; Chansky, Michael E.; Dellinger, R. Phillip; Parrillo, Joseph E.; Trzeciak, Stephen

doi:10.1111/j.1553-2712.2008.00102.x

Cited by 45 publications

(26 citation statements)

References 21 publications

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“…50 -52 Although a theoretical concern is that rapid fluid loading could have adverse cardiopulmonary effects such as pulmonary edema, 9 case series indicate that cooling can be initiated safely with IV ice-cold fluids (500 mL to 30 mL/kg of saline 0.9% or Ringer's lactate). [51][52][53][54][55][56][57][58][59] One human case series 56 showed that the deterioration in oxygenation that often occurs after ROSC was not significantly affected by the infusion of cold fluids (3427 mL Ϯ 210 mL). Two randomized controlled trials, 60,61 one study with concurrent controls, 62 and 3 case series 63,64 indicate that cooling with IV cold saline can be initiated safely in the prehospital setting.…”

Section: Targeted Temperature Management Induced Hypothermiamentioning

confidence: 99%

Part 9: Post–Cardiac Arrest Care

Peberdy¹,

Callaway²,

Neumar³

et al. 2010

Circulation

1,459

838

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Section: Targeted Temperature Management Induced Hypothermiamentioning

confidence: 99%

Part 9: Post–Cardiac Arrest Care

Peberdy¹,

Callaway²,

Neumar³

et al. 2010

Circulation

1,459

838

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“…189 For the critical outcome of survival, very-low-quality evidence (downgraded for risks of bias and publication bias) from 2 retrospective single-center studies including 2282 patients showed reduced survival for patients with post-ROSC SBP less than 90 mm Hg 190 and less than 100 mm Hg. 191 …”

Section: Titration Of Therapy To Achieve a Specific Hemodynamic Goal mentioning

confidence: 99%

Part 4: Advanced Life Support

Nolan¹,

Hazinski²,

Aickin³

et al. 2015

Circulation

557

125

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Questions to be addressed (using the PICO [population, intervention, comparator, outcome] format) 3 were prioritized by ALS Task Force members (by voting). Prioritization criteria included awareness of significant new data and new controversies or questions about practice. Questions about topics no longer relevant to contemporary practice or where little new research has occurred were given lower priority. The ALS Task Force prioritized 42 PICO questions for review. With the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evaluation. The reviewers for each question created a reconciled risk of bias assessment for each of the included studies, using state-of-the-art tools: Cochrane for randomized controlled trials (RCTs), 4 Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 for studies of diagnostic accuracy, 5 and GRADE for observational studies that inform both therapy and prognosis questions. 6 GRADE evidence profile tables 7 were then created to facilitate an evaluation of the evidence in support of each of the critical and important outcomes. The quality of the evidence (or confidence in the estimate of the effect) was categorized as high, moderate, low, or very low, 8 based on the study methodologies and the 5 core GRADE domains of risk of bias, inconsistency, indirectness, imprecision, and other considerations (including publication bias). 9 These evidence profile tables were then used to create a written summary of evidence for each outcome (the consensus on science statements). Whenever possible, consensus-based treatment recommendations were then created. These recommendations (designated as strong or weak) were accompanied by an overall assessment of the evidence and a statement from the task force about the values, preferences, and task force insights that underlie the recommendations. Further details of the methodology that underpinned the evidence evaluation process are found in "Part 2: Evidence Evaluation and Management of Conflicts of Interest."The task force preselected and ranked outcome measures that were used as consistently as possible for all PICO questions. Longer-term, patient-centered outcomes were considered more important than process variables and shorter-term outcomes. For most questions, we used the following hierarchy starting with the most important: long-term survival with neurologically favorable survival, long-term survival, short-term survival, and process variable. In general, longterm was defined as from hospital discharge to 180 days or longer, and short-term was defined as shorter than to hospital discharge. For certain questions (eg, related to defibrillation or confirmation of tracheal tube position), process variables such as termination of fibrillation and correct tube placement were important. A few questions (eg, organ donation) required unique outcomes....

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“…Seven studies documented the use of cooling blankets or pads alone to induce and maintain hypothermia (LOE 2 857 ; LOE 3 858 ; LOE 4 841,859 -862 ). Eight studies documented the use of water-circulating, gelcoated pads to induce and maintain, or just maintain, hypothermia (LOE 3 749,831 ; LOE 4 838,841,842,854,860,863 ). One RCT (LOE 1) used a cold-air tent 822 and another used a cooling helmet 827 to induce and maintain hypothermia.…”

Section: Consensus On Sciencementioning

confidence: 99%