P0159 / #318: TEMPERATURE MANAGEMENT AUDIT POST PAEDIATRIC CARDIAC ARREST: NET-PACK 2

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Aims & Objectives: Targeted temperature management (TTM) aims to reduce neurological injury from hypoxic ischemia after cardiac arrest (CA). 2010 International guidance recommended TTM >32 and <37.5 degrees. We assessed factors associated with TTM choice at paediatric intensive care (PIC) admission (No TTM, Active Normothermia (AN: 35.0-37.9°C) or Active Hypothermia (AH: 32.0-34.9°C). Methods: NET-PACK2 included patients from the Paediatric Intensive Care Audit Network admitted to 20 UK and Republic of Ireland PICs (Aug 2014 to Jan 2016) after out-of-hospital or in-hospital CA, aged <16years, cardiopulmonary resuscitation (CPR) ≥1 minute and requiring ventilation. Exclusion: choice of TTM unrecorded and death <6hours post admission. Primary outcome: choice of TTM. Evaluation of factors associated with TTM and survival to PIC discharge. Results: Of 423 patients, 287 were included from 20 PICs. Overall age was median 0.9 [IQR: 0.2-6.6] years, with 66% males & 52% out-of-hospital CA. 100(35%) received no TTM, 138(48%) were treated with AN and 49(17%) treated with AH. Fever (≥38°C) was recorded in 24%, with no significant difference between groups. Active TTM was received for ≥24 hours in 55% (Table1). A median of 10 patients [IQR: 7-22] were admitted per PIC, with considerable variation in choice of temperature management between PICs. 95% of PICs used AN and 75% used no TTM. Admitting PICs and duration of CPR was associated with choice of TTM in logistic regression analysis. Overall survival between groups was similar.Conclusions: The use of TTM is highly variable in PICs and exposure to fever remains common. Clearer post-CA guidance may reduce variation.

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