Reported practice of temperature adjustment (α-stat v pH-stat) for arterial blood gases measurement among investigators from two major cardiac arrest trials

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Abstract

Background: Two major cardiac arrest trials are evaluating different strategies that may potentially mitigate neurological injury after cardiac arrest and are allowing co-enrolment. However, one trial will target hypothermia and the other will target mild hypercapnia, in which the carbon dioxide (CO 2 ) measurement may be influenced by the choice of temperature adjustment during arterial blood gases (ABGs) measurement. The trials have agreed to standardise assessment by the α-stat method. Objectives: To describe the Targeted Therapeutic Mild Hypercapnia after Resuscitated Cardiac Arrest (TAME) and Targeted Hypothermia versus Targeted Normothermia after Out-of-hospital Cardiac Arrest (TTM2) site investigators’ self-reported practice of ABG analysis and, in particular, their view of whether α-stat or pH-stat assessment of ABGs is considered optimal. Methods: We performed an online anonymous multichoice survey. Of the 136 site investigators emailed, 70 (51%) responded. Of these, 19 (27%) were participating in the TAME trial only, 22 (31%) were in TTM2 only, and 29 (41%) were participating in both. Results: The majority of respondents identified α-stat (41/68, 60%) compared with pH-stat (27/68, 40%) as their usual approach to ABG analysis when targeting 33°C. In addition, the proportion and pattern of concern over hyperventilation was similarly reported as either “not concerned” or “neutral” when using an α-stat (46/69, 66%) or pH-stat (50/68, 73%) ABG analysis approach. Finally, for the purpose of a randomised controlled trial, most respondents either “strongly agreed”, “agreed” or “neither agreed nor disagreed” to use the α-stat (59/69, 85%) or the pH-stat (61/70, 87%) approach. Conclusion: Our survey findings support the acceptability of the decision to apply the α-stat approach across participating sites for both trials.

Original languageEnglish
Pages (from-to)69-71
Number of pages3
JournalCritical Care and Resuscitation
Volume21
Issue number1
Publication statusPublished - 1 Mar 2019

Cite this

@article{a967c8889ff940cebbd42a2c7fb3e392,
title = "Reported practice of temperature adjustment (α-stat v pH-stat) for arterial blood gases measurement among investigators from two major cardiac arrest trials",
abstract = "Background: Two major cardiac arrest trials are evaluating different strategies that may potentially mitigate neurological injury after cardiac arrest and are allowing co-enrolment. However, one trial will target hypothermia and the other will target mild hypercapnia, in which the carbon dioxide (CO 2 ) measurement may be influenced by the choice of temperature adjustment during arterial blood gases (ABGs) measurement. The trials have agreed to standardise assessment by the α-stat method. Objectives: To describe the Targeted Therapeutic Mild Hypercapnia after Resuscitated Cardiac Arrest (TAME) and Targeted Hypothermia versus Targeted Normothermia after Out-of-hospital Cardiac Arrest (TTM2) site investigators’ self-reported practice of ABG analysis and, in particular, their view of whether α-stat or pH-stat assessment of ABGs is considered optimal. Methods: We performed an online anonymous multichoice survey. Of the 136 site investigators emailed, 70 (51{\%}) responded. Of these, 19 (27{\%}) were participating in the TAME trial only, 22 (31{\%}) were in TTM2 only, and 29 (41{\%}) were participating in both. Results: The majority of respondents identified α-stat (41/68, 60{\%}) compared with pH-stat (27/68, 40{\%}) as their usual approach to ABG analysis when targeting 33°C. In addition, the proportion and pattern of concern over hyperventilation was similarly reported as either “not concerned” or “neutral” when using an α-stat (46/69, 66{\%}) or pH-stat (50/68, 73{\%}) ABG analysis approach. Finally, for the purpose of a randomised controlled trial, most respondents either “strongly agreed”, “agreed” or “neither agreed nor disagreed” to use the α-stat (59/69, 85{\%}) or the pH-stat (61/70, 87{\%}) approach. Conclusion: Our survey findings support the acceptability of the decision to apply the α-stat approach across participating sites for both trials.",
author = "Eastwood, {Glenn M} and Niklas Nielsen and Nichol, {Alistair D} and Skrifvars, {Markus B} and Craig French and Rinaldo Bellomo",
year = "2019",
month = "3",
day = "1",
language = "English",
volume = "21",
pages = "69--71",
journal = "Critical Care and Resuscitation",
issn = "1441-2772",
publisher = "Australasian Medical Publishing Co. Pty Ltd. (AMPCo)",
number = "1",

}

TY - JOUR

T1 - Reported practice of temperature adjustment (α-stat v pH-stat) for arterial blood gases measurement among investigators from two major cardiac arrest trials

AU - Eastwood, Glenn M

AU - Nielsen, Niklas

AU - Nichol, Alistair D

AU - Skrifvars, Markus B

AU - French, Craig

AU - Bellomo, Rinaldo

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background: Two major cardiac arrest trials are evaluating different strategies that may potentially mitigate neurological injury after cardiac arrest and are allowing co-enrolment. However, one trial will target hypothermia and the other will target mild hypercapnia, in which the carbon dioxide (CO 2 ) measurement may be influenced by the choice of temperature adjustment during arterial blood gases (ABGs) measurement. The trials have agreed to standardise assessment by the α-stat method. Objectives: To describe the Targeted Therapeutic Mild Hypercapnia after Resuscitated Cardiac Arrest (TAME) and Targeted Hypothermia versus Targeted Normothermia after Out-of-hospital Cardiac Arrest (TTM2) site investigators’ self-reported practice of ABG analysis and, in particular, their view of whether α-stat or pH-stat assessment of ABGs is considered optimal. Methods: We performed an online anonymous multichoice survey. Of the 136 site investigators emailed, 70 (51%) responded. Of these, 19 (27%) were participating in the TAME trial only, 22 (31%) were in TTM2 only, and 29 (41%) were participating in both. Results: The majority of respondents identified α-stat (41/68, 60%) compared with pH-stat (27/68, 40%) as their usual approach to ABG analysis when targeting 33°C. In addition, the proportion and pattern of concern over hyperventilation was similarly reported as either “not concerned” or “neutral” when using an α-stat (46/69, 66%) or pH-stat (50/68, 73%) ABG analysis approach. Finally, for the purpose of a randomised controlled trial, most respondents either “strongly agreed”, “agreed” or “neither agreed nor disagreed” to use the α-stat (59/69, 85%) or the pH-stat (61/70, 87%) approach. Conclusion: Our survey findings support the acceptability of the decision to apply the α-stat approach across participating sites for both trials.

AB - Background: Two major cardiac arrest trials are evaluating different strategies that may potentially mitigate neurological injury after cardiac arrest and are allowing co-enrolment. However, one trial will target hypothermia and the other will target mild hypercapnia, in which the carbon dioxide (CO 2 ) measurement may be influenced by the choice of temperature adjustment during arterial blood gases (ABGs) measurement. The trials have agreed to standardise assessment by the α-stat method. Objectives: To describe the Targeted Therapeutic Mild Hypercapnia after Resuscitated Cardiac Arrest (TAME) and Targeted Hypothermia versus Targeted Normothermia after Out-of-hospital Cardiac Arrest (TTM2) site investigators’ self-reported practice of ABG analysis and, in particular, their view of whether α-stat or pH-stat assessment of ABGs is considered optimal. Methods: We performed an online anonymous multichoice survey. Of the 136 site investigators emailed, 70 (51%) responded. Of these, 19 (27%) were participating in the TAME trial only, 22 (31%) were in TTM2 only, and 29 (41%) were participating in both. Results: The majority of respondents identified α-stat (41/68, 60%) compared with pH-stat (27/68, 40%) as their usual approach to ABG analysis when targeting 33°C. In addition, the proportion and pattern of concern over hyperventilation was similarly reported as either “not concerned” or “neutral” when using an α-stat (46/69, 66%) or pH-stat (50/68, 73%) ABG analysis approach. Finally, for the purpose of a randomised controlled trial, most respondents either “strongly agreed”, “agreed” or “neither agreed nor disagreed” to use the α-stat (59/69, 85%) or the pH-stat (61/70, 87%) approach. Conclusion: Our survey findings support the acceptability of the decision to apply the α-stat approach across participating sites for both trials.

UR - http://www.scopus.com/inward/record.url?scp=85062819539&partnerID=8YFLogxK

M3 - Article

VL - 21

SP - 69

EP - 71

JO - Critical Care and Resuscitation

JF - Critical Care and Resuscitation

SN - 1441-2772

IS - 1

ER -