{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T21:07:07Z","timestamp":1761253627732,"version":"3.40.5"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T00:00:00Z","timestamp":1660608000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005754","name":"Sahlgrenska Universitetssjukhuset","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005754","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Post\u2010resuscitation care of comatose survivors from cardiac arrest includes target temperature management (TTM) to mitigate cerebral reperfusion injury. High\u2010quality TTM requires protocols enhancing good precision. This study explored how the quality of TTM may have evolved with increasing experience from clinical trial protocols and standard operating procedures. We hypothesized that there would be a positive effect over time, detectable between trial periods and between trial periods and later everyday practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three TTM quality parameters were defined: time to target, temperature variability, and fever incidence. Data from 181 patients treated during three different time periods in a tertiary center were analyzed; 45 from Period 1 (local trial cohort 2011\u20132013) targeting 33\u00b0C or 36\u00b0C; 76 from Period 2 (local trial cohort 2018\u20132020) targeting 33 or &lt;37.5\u00b0C; 60 from Period 3 (current standard operating procedure 2020\u20132021) targeting 36\u00b0C. Groups of similar target temperatures from different time periods were compared using ordinary group statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>TTM quality in all three parameters increased between trial periods. There were no differences in TTM quality as to temperature variability or fever incidence between the &lt;37.5\u00b0C Period 2 and the 36\u00b0C Period 3 groups. A 33\u00b0C target temperature was associated with lower fever incidence than 36\u00b0C and &lt;37.5\u00b0C target regimes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The observed increase in TTM quality in this single\u2010center study may be a result of increased competence through learning and training in different strict TTM protocols. If so, the results of this study further support the protocolization of post\u2010cardiac arrest intensive care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14125","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T07:19:12Z","timestamp":1659597552000},"page":"1116-1123","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Targeted temperature management evolving over time\u2014A local process analysis"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6298-8809","authenticated-orcid":false,"given":"Axel","family":"Str\u00e5lin","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg, Sahlgrenska University Hospital  Gothenburg 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