• Nicola Gasparetto, Daniele Scarpa, Sandra Rossi, Paolo Persona, Luigi Martano, Andrea Bianchin, Carlo Alberto Castioni, Carlo Ori, Sabino Iliceto, and Luisa Cacciavillani.
• Cardiology Clinic, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padua, via Giustiniani 2, 35128 Padua, Italy. Electronic address: gasparetto.nicola@gmail.com.
• Resuscitation. 2014 Mar 1;85(3):376-80.

BackgroundTherapeutic hypothermia (TH) is one of three interventions that have demonstrated to improve patients' neurological outcome after cardiac arrest. The aim of this study was to investigate the effect of the 2010 resuscitation guidelines on TH implementation in various Italian Intensive Care Units (ICU).MethodsA structured questionnaire was submitted to Italian ICU. The questionnaire was addressed to determine the procedures of TH in each ICU or, on the contrary, the reason for not employing the therapy.ResultsWe obtained complete information from 770 of 847 Italian ICU (91%). Out of 405 Units included in the analysis only 223 (55.1%) reported to use TH in comatose patients after return of spontaneous circulation. The trend of TH implementation shows a stable increase, particularly after 2006 but there is no evident acceleration after the strong indication of the 2010 guidelines. There was a rise of about 3.4 times in the number of Italian ICU using TH as compared to the 2007 survey (an increase of 68% per year). One hundred and eighty-two (44.9%) units did not use TH mainly because of lack of equipment, economic issues or the conviction of the difficulty of execution.ConclusionsTH is still under-used in Italy (55.1%) even though the therapy is strongly recommended in the 2010 guidelines. However, the increase in the adoption of hypothermia has been significant in the past 5 years (68%/years) and the awareness of the efficacy is almost consolidated among intensivists, being logistic problems the leading cause for non-adoption.Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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