Targeted temperature management and cardiac arrest after the TTM-2 study

Excerpt

The use of targeted temperature management (TTM) has been recommended for two decades in the management of patients after cardiac arrest; however, the quality of evidence behind this recommendation is moderate to low and refers only to out-of-hospital cardiac arrest (OHCA) [1‐4]. Recently, Dankiewicz et al. (TTM-2 study) reported that TTM at 33 °C did not lower the incidence of death or 6-month poor neurological outcome than targeted normothermia in 1900 unconscious OHCA patients [5], with more arrhythmias resulting in hemodynamic compromise observed in the 33 °C group. There was no benefit of hypothermia in any of the prespecified sub-groups, including age, initial rhythm or duration of resuscitation. It is likely that these recent data will affect the use of TTM in clinical practice. …