Abstract Su1206: Reduced Time to Goal Therapeutic Hypothermia With Implementation of a Post Cardiac Arrest Consult Service

Introduction: Critical care after advanced cardiac life support can be pivotal for survival and outcomes in patients with out-of-hospital cardiac arrest (OHCA). Prior studies have demonstrated improvements in survival after OHCA with shorter door-to-therapeutic hypothermia (TH) initiation times. Post-cardiac arrest consult teams (PCACT) can facilitate TH to goal 33°C and other aspects of post-arrest care. However, the effects of such a service on TH have not been consistently quantified. Hypothesis: More OHCA patients would undergo TH and reach goal temperature sooner following implementation of a PCACT. Aims: We aim to evaluate the effectiveness of a PCACT in optimizing TH in survivors of OHCA. Methods: We conducted a retrospective chart review of 305 patients admitted between January 1, 2021 and December 31, 2022. Implementation of a dedicated PCACT, comprised of a neurointensivist and an advanced practice provider or neurocritical care fellow, occurred on January 1, 2022. The PCACT was active on weekdays only. One year before and after this date were designated as “pre-PCACT” and “post-PCACT”, respectively. De-identified patient demographics, clinical features of cardiac arrest, and TH data were collected and compared using Wilcoxon rank-sum and Chi-squared tests for continuous and categorical variables, respectively. Results: Of the 305 patients admitted during the study period, 149 were in the pre-PCACT group and 156 were in the post-PCACT group. Baseline demographics between the two groups were similar except that the post-PCACT group had more patients with non-shockable rhythms (64% vs. 54%, p =0.001). Patients were not cooled to 33°C more frequently (50 vs. 52%) pre- or post-PCACT. TH to 33°C was performed in 156 (51%) patients, 78 patients (50%) pre- and post-PCACT implementation. There were no baseline demographic or temperature differences between the two groups amongst patients undergoing TH to 33°C. Post-PCACT patients were quicker to reach 33°C (1.6 vs. 3 hours, p =0.001). After PCACT implementation, this difference was noted during weekdays but not during weekends (1.3 vs. 2.7 hours, p =0.05).There were no differences in survival or neurologic outcomes pre- and post-PCACT introduction, nor between patients who were or were not cooled to 33C. Conclusion(s): Implementation of a PCACT may streamline care to reduce time to goal temperature during TH. However, further study is required to determine whether a PCACT can improve outcomes.