• Chiara De Fazio, Markus B Skrifvars, Eldar Søreide, Anders M Grejs, Eugenio Di Bernardini, Anni Nørgaard Jeppesen, Christian Storm, Jesper Kjaergaard, Timo Laitio, Bodil Sten Rasmussen, Marjaana Tianen, Hans Kirkegaard, Fabio Silvio Taccone, and TTH48 Investigators.
• Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
• Resuscitation. 2021 Aug 1; 165: 85-92.

BackgroundNo data are available on the quality of targeted temperature management (TTM) provided to out-of-hospital cardiac arrest (OHCA) patients and its association with outcome.MethodsPost hoc analysis of the TTH48 study (NCT01689077), which compared the effects of prolonged TTM at 33 °C for 48 h to standard 24-h TTM on neurologic outcome. Admission temperature, speed of cooling, rewarming rates, precision (i.e. temperature variability), overcooling and overshooting as post-cooling fever (i.e. >38.0 °C) were collected. A specific score, ranging from 1 to 9, was computed to define the "quality of TTM".ResultsOn a total of 352 patients, most had a moderate quality of TTM (n = 217; 62% - score 4-6), while 80 (23%) patients had a low quality of TTM (score 1-3) and only 52 (16%) a high quality of TTM (score 7-9). The proportion of patients with unfavorable neurological outcome (UO; Cerebral Performance Category of 3-5 at 6 months) was similar between the different quality of TTM groups (p = 0.90). Although a shorter time from arrest to target temperature and a lower proportion of time outside the target ranges in the TTM 48-h than in the TTM 24-h group, quality of TTM was similar between groups. Also, the proportion of patients with UO was similar between the different quality of TTM groups when TTM 48-h and TTM 24-h were compared.ConclusionsIn this study, high quality of TTM was provided to a small proportion of patients. However, quality of TTM was not associated with patients' outcome.Copyright © 2021 Elsevier B.V. All rights reserved.

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