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Curr Opin Crit Care · Oct 2024
Does targeted temperature management at 33 °C improve outcome after cardiac arrest?
- Markus B Skrifvars and Benjamin S Abella.
- Department of Emergency Care and Services, University of Helsinki, Helsinki University Hospital, Finland.
- Curr Opin Crit Care. 2024 Oct 21.
Purpose Of ReviewFollowing successful resuscitation from cardiac arrest, a complex set of pathophysiologic processes are acutely triggered, leading to substantial morbidity and mortality. Postarrest management remains a major challenge to critical care providers, with few proven therapeutic strategies to improve outcomes. One therapy that has received substantial focus is the intentional lowering of core body temperature for a discrete period of time following resuscitation. In this review, we will discuss the key trials and other evidence surrounding TTM and present opposing arguments, one 'against' the use of postarrest TTM and another 'for' the use of this therapeutic approach.Recent FindingsTargeted temperature management, has been a topic of enormous controversy, as recently a number of clinical trials show conflicting results on the effect of TTM. Fundamental questions, about the dosing of TTM (e.g. use at 33 °C versus higher temperatures), or the use of TTM at all (as opposed to passive fever avoidance), remain active topics of global discussion. Systematic reviews on this topic also show variable results.SummaryThere are several arguments for and against the use of TTM targeting 33 °C for alleviating brain injury after cardiac arrest. More studies are on the way that will hopefully provide more robust evidence and hopefully allow for consensus on this important topic.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
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