Formal guidelines recommend that therapeutic hypothermia
be considered after in-hospital cardiac arrest
. The rate of therapeutic hypothermia
use after in-hospital cardiac arrest
and details about its implementation are unknown. We aimed to determine the use of therapeutic hypothermia
for adult in-hospital cardiac arrest
, whether use has increased over time, and to identify factors associated with its use.
Multicenter, prospective cohort study.
A total of 538 hospitals participating in the Get With the Guidelines-Resuscitation database (2003–2009).
A total of 67,498 patients who had return of spontaneous circulation after in-hospital cardiac arrest
Measurements and Main Results:
The primary outcome was the initiation of therapeutic hypothermia
. We measured the proportion of therapeutic hypothermia
patients who achieved target temperature (32–34°C) and were overcooled. Of 67,498 patients, therapeutic hypothermia
was initiated in 1,367 patients (2.0%). The target temperature (32–34°C) was not achieved in 44.3% of therapeutic hypothermia
patients within 24 hours and 17.6% were overcooled. The use of therapeutic hypothermia
increased from 0.7% in 2003 to 3.3% in 2009 (p
< 0.001). We found that younger age (p
< 0.001) and occurrence in a non-ICU location (p
< 0.001), on a weekday (p
= 0.005), and in a teaching hospital (p
= 0.001) were associated with an increased likelihood of therapeutic hypothermia
After in-hospital cardiac arrest
, therapeutic hypothermia
was used rarely. Once initiated, the target temperature was commonly not achieved. The frequency of use increased over time but remained low. Factors associated with therapeutic hypothermia
use included patient age, time and location of occurrence, and type of hospital.