TTM at our Cardiac Arrest Center
At the Charité-Universitätsmedizin Berlin TTM is an established part of standard therapy after resuscitation for many years now. The therapy follows a routinely revised, written Standard Operating Protocol (SOP), which spells out in detail all steps of the therapy as well as possible complications and their therapy.
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In order to guarantee the optimal treatment for our patients we perform training sessions for physicians and nursing staff several times a year. In addition we have identified multipliers in our staff who serve as contact persons for the whole team. That way we can be sure that every patient receives a state-of-the-art therapy in accordance with the newest results of clinical research and guidelines of the medical associations. An integral component of our standard protocol is the evaluation of neurological prognosis after resuscitation and TTM. It is known that previously applied biomarkers and functional testing can be influenced by TTM and thus must be interpreted differently (for example threshold values).
The prognosis algorithms are constantly revised and adapted to the current research. This represents a further constituent for a secure and valid prognosis assessment at the Charité - Universitätsmedizin Berlin.
Within the framework of our quality control the therapy outcomes are pseudonymously archived and can be retrieved from a data bank.
Until now more than 800 patients have been treated with TTM at the Charité.
The Charité Experience
After introduction of TTM at the Charité the neurological outcome of our patients has significantly improved in comparison with a historical control group. A confounder in the neurological evaluation is the so-called "self-fulfilling prophecy", that is, a poor outcome is expected due to unfavorable examination results or the circumstance of a long duration of cardiac arrest and thus the prophecy occurs due to an unconscious withdrawal of therapy. In order to avoid this phenomenon our patients are initially treated for at least one week at the Intensive Care Unit and neurological examinations at various time points are made.