Advertisement

Targeted temperature management after cardiac arrest: And the optimal target is….?

  • Kees H. Polderman
    Affiliations
    Department of Intensive Care, The Essex Cardiothoracic Centre, Basildon University Hospital, United Kingdom

    Department of Critical Care Medicine, United General Hospital, Houston, TX 77054, United States

    The University of Texas Health Science Center at Houston, United Memorial Medical Center, Houston, TX United States
    Search for articles by this author
  • Joseph Varon
    Correspondence
    Corresponding author at: Department of Intensive Care, The Essex Cardiothoracic Centre, Basildon University Hospital, United Kingdom.
    Affiliations
    Department of Critical Care Medicine, United General Hospital, Houston, TX 77054, United States

    The University of Texas Health Science Center at Houston, United Memorial Medical Center, Houston, TX United States
    Search for articles by this author
      The publication of the targeted temperature management (TTM) trial in November 2013
      • Nielsen N.
      • Wetterslev J.
      • Cronberg T.
      • et al.
      TTM trial investigators. Targeted temperature management at 33 °C versus 36 °C after cardiac arrest.
      led to heated discussions regarding the optimal temperature for cooling after cardiac arrest (CA). Regardless of one´s view on this issue, it is clear that significant confusion ensued.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Resuscitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Nielsen N.
        • Wetterslev J.
        • Cronberg T.
        • et al.
        TTM trial investigators. Targeted temperature management at 33 °C versus 36 °C after cardiac arrest.
        N Engl J Med. 2013; 369: 2197-2206
        • Friberg Cronberg T.
        • Nielsen N.
        Reply to target temperature management for post-cardiac arrest patients.
        Ther Hypothermia Temp Manage. 2015; 5: 2-3
        • Wise M.P.
        • Horn J.
        • Åneman A.
        • Nielsen N.
        Targeted temperature management after out-of-hospital cardiac arrest: certainties and uncertainties.
        Crit Care. 2014; 18: 459
        • Rittenberger J.C.
        • Callaway C.W.
        Temperature management and modern post-cardiac arrest care.
        N Engl J Med. 2013; 369: 2262-2263
        • Polderman K.H.
        • Varon J.
        We should not abandon therapeutic cooling after cardiac arrest.
        Crit Care. 2014; 18: 130
        • Polderman K.H.
        • Varon J.
        How low should we go? Hypothermia or strict normothermia after cardiac arrest?.
        Circulation. 2015; 131: 669-675
        • Soar J.
        • Nolan J.P.
        • Böttiger B.W.
        • et al.
        Deakin CD; adult advanced life support section collaborators. European resuscitation council guidelines for resuscitation 2015: section 3. Adult advanced life support.
        Resuscitation. 2015; 95: 100-147
        • Geocadin R.G.
        • Wijdicks E.
        • Armstrong M.J.
        • et al.
        Practice guideline summary: reducing brain injury following cardiopulmonary resuscitation: report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology.
        Neurology. 2017; 88: 2141-2149
        • Rittenberger J.C.
        • Friess S.
        • Polderman K.H.
        Emergency neurological life support: resuscitation following cardiac arrest.
        Neurocrit Care. 2015; 23: S119-S128
        • Bradley S.M.
        • Liu W.
        • McNally B.
        • et al.
        Temporal trends in the use of therapeutic hypothermia for out-of-hospital cardiac arrest.
        JAMA Network Open. 2018; 1e184511
        • Polderman K.H.
        Mechanisms of action, physiological effects, and complications of hypothermia.
        Crit Care Med. 2009; 37: S186-S202
        • Coppler P.J.
        • Marill K.A.
        • Okonkwo D.O.
        • et al.
        Concordance of brain and core temperature in comatose patients after cardiac arrest.
        Ther Hypothermia Temp Manage. 2016; 6: 194-197
      1. NCT reference number NCT02908308 (https://clinicaltrials.gov/ct2/show/NCT02908308, (Accessed 22 November 2019).

        • Bray J.E.
        • Stub D.
        • Bloom J.E.
        • et al.
        Changing target temperature from 33 °C to 36 °C in the ICU management of out-of-hospital cardiac arrest: a before and after study.
        Resuscitation. 2017; 113: 39-43
        • Salter R.
        • Bailey M.
        • Bellomo R.
        • et al.
        Changes in temperature management of cardiac arrest patients following publication of the target temperature management trial.
        Crit Care Med. 2018; 46: 1722-1730
        • Johnson N.J.
        • Danielson K.R.
        • Counts C.R.
        • et al.
        Targeted temperature management at 33 versus 36 degrees: a retrospective cohort study.
        Crit Care Med. 2019; (in press)
        • Johnsson J.
        • Wahlström J.
        • Dankiewicz J.
        • et al.
        Functional outcomes associated with varying levels of targeted temperature management after out-of-hospital cardiac arrest - an INTCAR2 registry analysis.
        Resuscitation. 2019; (Nov 9. pii: S0300-9572(19)30669-0)https://doi.org/10.1016/j.resuscitation.2019.10.020
        • Jacobshagen C.
        • Pelster T.
        • Pax A.
        • et al.
        Effects of mild hypothermia on hemodynamics in cardiac arrest survivors and isolated failing human myocardium.
        Clin Res Cardiol. 2010; 99: 267-276
        • Roberts B.W.
        • Kilgannon J.H.
        • Chansky M.E.
        • et al.
        Therapeutic hypothermia and vasopressor dependency after cardiac arrest.
        Resuscitation. 2013; 84: 331-336
        • Zobel C.
        • Adler C.
        • Kranz A.
        • et al.
        Mild therapeutic hypothermia in cardiogenic shock syndrome.
        Crit Care Med. 2012; 40: 1715-1723
        • Fuernau G.
        • Beck J.
        • Desch S.
        • et al.
        Mild hypothermia in cardiogenic shock complicating myocardial infarction.
        Circulation. 2019; 139: 448-457
        • Nolan J.P.
        • Neumar R.W.
        • Adrie C.
        • et al.
        Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A scientific statement from the international liaison committee on resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; The Council on Cardiovascular Surgery and Anesthesia; The Council on Cardiopulmonary, Perioperative, and Critical Care; The Council on Clinical Cardiology; The Council on Stroke.
        Resuscitation. 2008; 79: 350-379
        • Polderman K.H.
        • Herold I.
        Therapeutic hypothermia and controlled normothermia in the intensive care unit: practical considerations, side effects, and cooling methods.
        Crit Care Med. 2009; 37: 1101-1120
        • Kirkegaard H.
        • Søreide E.
        • de Haas I.
        • et al.
        Targeted temperature management for 48 vs 24 h and neurologic outcome after out-of-hospital cardiac arrest: a randomized clinical trial.
        JAMA. 2017; 318: 341-350