Targeted temperature management (TTM) is recommended after successful resuscitation from out-of-hospital cardiac arrest with an initially shockable rhythm (VF/pVT). The target temperature range according to current evidence is:

• A 32–34°C for 24 hours (traditional therapeutic hypothermia)
• B 36°C for 24 hours (preventing fever, normothermia-directed TTM)
• C 38°C to induce mild therapeutic hyperthermia for neuroprotection
• D 32–36°C for at least 24 hours (either target acceptable, prevention of fever essential) ✓

Explanation

Based on the TTM trial (2013) and TTM2 trial (2021), the optimal target temperature remains debated: TTM-2 showed no significant difference between 33°C and normothermia (37.5°C), but the key finding across both trials is that active prevention of fever (>37.8°C) is mandatory. Current AHA 2020 guidelines recommend maintaining a constant target temperature between 32–36°C for at least 24 hours in comatose post-cardiac arrest patients, with fever prevention being the minimum standard. Rewarming should not exceed 0.25–0.5°C per hour. Hyperthermia is actively harmful and contraindicated.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.