Content area
Full Text
Nielsen, et al.; TTM Trial Investigators. Targeted Temperature Management at 338 C versus 368 C after Cardiac Arrest. N Engl J Med (3)
Reviewed by Anthony F. Arredondo
Therapeutic hypothermia, generally defined as targeted temperature management with a goal temperature of 32-348 C, has been shown to improve both survival and neurologic function in two previous trials for unconscious patients in out-of-hospital cardiac arrests with shockable rhythms (4, 5). Based on these trials, international guidelines have extended the use of therapeutic hypothermia for cardiac arrest to those with nonshockable rhythms and in-hospital cardiac arrests (6). Debate has persisted regarding the generalizability of these guidelines and the true efficacy of therapeutic hypothermia. In one study (4), a greater incidence of fever in the control group, which portends worse outcomes, led some to conclude that the treatment effect was due to fever prevention rather than therapeutic...