Results and generalizability of the Target Temperature Management Trial and future research for patients admitted to intensive care after cardiac arrest

Excerpt

The Target Temperature Management (TTM) Trial randomized 950 unconscious, adult patients with return of spontaneous circulation after out-of-hospital cardiac arrest (CA) of presumed cardiac cause to strict temperature management at either 33°C or 36°C. Temperature was managed with intravascular or surface cooling devices for 36 hours, while the patients were sedated and mechanically ventilated. Prognostication and decisions on life-sustaining treatments were postponed until 4.5 to 5 days after CA in the general case [1]. There was no difference in the primary outcome: survival until the end of the trial (mortality 50% in the 33°C group and 48% in the 36°C group, hazard ratio 1.06, 95% confidence interval 0.89 to 1.28, p = 0.51) or the secondary outcomes: neurological function at 6 months and adverse events [2]. In a substudy with detailed cognitive assessment, the groups were similar [3]. …