Key result
Targeted temperature management at 33 °C did not lower the incidence of death or 6-month poor neurological outcome compared to targeted normothermia in unconscious patients with out-of-hospital cardiac arrest.
Why the study?
Does targeted temperature management at 33 °C reduce death or poor neurological outcome in unconscious out-of-hospital cardiac arrest patients?
Does targeted temperature management at 33 °C reduce death or poor neurological outcome in unconscious out-of-hospital cardiac arrest patients?
Active maintenance of normothermia appears to be the optimal strategy for cardiac arrest of cardiac origin with early resuscitation, challenging the historical routine use of hypothermia at 33 °C.
© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecom‐ mons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Background 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.
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Taccone et al. (2021) conducted an editorial in Out-of-hospital cardiac arrest (n=1,861). Targeted temperature management vs. Targeted normothermia was evaluated on Incidence of death or 6-month poor neurological outcome. Targeted temperature management at 33 °C did not lower the incidence of death or 6-month poor neurological outcome compared to targeted normothermia in unconscious patients with out-of-hospital cardiac arrest.
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