Purpose:
Current European Resuscitation Council (ERC) guidelines recommend TTM of 32°C-36°C for patients with return of spontaneous circulation (ROSC) following cardiac arrest[1] although this remains controversial following recent published research[2][3]. A review of compliance with ERC recommendations was undertaken on our Intensive Care Unit (ICU) with a view to updating practice.

Methods:
A retrospective analysis of adults admitted to ICU with ROSC post-cardiac arrest over a 12 month period 2017/18. 

Data collected:
-	Location of  arrest
-	Initial cardiac rhythm
-	TTM eligibility
-	Utilisation of active cooling
-	Achievement of desired temperature <36oC 
-	Time taken to reach temperature <36oC 
-	Episodes of fever >37.5 oC in first 72 hours

Results:
Data was obtained for 25 patients:
Of the 20 eligible patients:
-	2 were actively cooled
-	16 achieved temperature <36oC during the first 24 hours
-	1 met TTM range consistently for the first 24 hours
-	Average time temperature >36oC was 32 hours in first 72 hours post-arrest
-	Average 2.4 temperature spikes >37.5oC per patient

Conclusions:
Post-resuscitation TTM in our ICU did not meet ERC recommendations. We have created a comprehensive departmental TTM guideline to update our practice.

References:
1.	Nolan J et al. Post Resusciation Care. J Resuscitation 95(2015): 202-222
2.	Nielsen N et al. Targeted Temperature Management at 33°C versus 36°C after Cardiac Arrest. N Engl J Med. 2013 Dec 5; 369(23):2197–206
3.	Kirkegaard H et al. Targeted Temperature Management for 48 vs 24 Hours and Neurologic Outcome After Out-of-Hospital Cardiac Arrest. JAMA. 2017 Jul 25; 318(4):341.

6 - Quality Improvement Project: ERC recommendations for Targeted Temperature Management (TTM) following cardiac arrest at an inner city hospital. Dr Holly Esam, Dr Jessica Rogers & Dr Lawrence Tham, Intensive Care Unit, Homerton University Hospital, London, UK. Correspondence: holly-india.esam@nhs.net, jessica.rogers6@nhs.net