Targeted Temperature Management for Treatment of Cardiac Arrest

Tyler P. Rasmussen, T. C. Bullis, S. Girotra

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

Purpose of review: Cardiac arrest is a common condition associated with high mortality and a substantial risk of neurological injury among survivors. Targeted temperature management (TTM) is the only strategy shown to reduce the risk of neurologic disability cardiac arrest patients. In this article, we provide a comprehensive review of TTM with an emphasis on recent trials. Recent findings: After early studies demonstrating the benefit of TTM in out-of-hospital cardiac arrest due to a shockable rhythm, newer studies have extended the benefit of TTM to patients with a nonshockable rhythm and in-hospital cardiac arrest. A target temperature of 33 °C was not superior to 36 °C, suggesting that a lenient targeted temperature may be appropriate especially for patients unable to tolerate lower temperatures. Although early initiation of TTM appears to be beneficial, the benefit of prehospital cooling has not been shown and use of intravenous cold saline in the prehospital setting may be harmful. Summary: There is substantial risk of neurological injury in cardiac arrest survivors who remain comatose. TTM is an effective treatment that can lower the risk of neurological disability in such patients and ideally delivered as part of a comprehensive, goal-directed post-resuscitation management by a multidisciplinary team in a tertiary medical center.

Original languageEnglish (US)
Article number39
JournalCurrent Treatment Options in Cardiovascular Medicine
Volume22
Issue number11
DOIs
StatePublished - Nov 1 2020
Externally publishedYes

Keywords

  • Cardiac arrest
  • Targeted temperature management
  • Therapeutic hypothermia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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