In targeted temperature management (TTM) after out-of-hospital cardiac arrest with initial shockable rhythm, what is the recommended target temperature range per current guidelines and for how long?

• A 30–32°C for 48 hours
• B 36–37°C (fever avoidance only) for 72 hours
• C 32°C for 12 hours then gradual rewarming
• D 33–36°C for 24 hours following return of spontaneous circulation ✓

Explanation

Current AHA/ERC guidelines for TTM following cardiac arrest with return of spontaneous circulation (ROSC) recommend maintaining target temperature between 33°C and 36°C continuously for at least 24 hours, followed by active prevention of fever (>37.7°C) for 72 hours post-ROSC. The TTM-2 trial (2021) showed no superiority of 33°C over 37°C (strict fever prevention), leading to inclusion of 36°C as equally acceptable. Patients should not be allowed to become febrile during the 72-hour post-arrest period.

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

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Written and medically reviewed by the StethoPrep medical team.