Post-cardiac arrest targeted temperature management (TTM) is recommended after successfully resuscitated cardiac arrest. The target core temperature range per current evidence is:

• A 32–34°C for 24 hours (strict hypothermia protocol)
• B 33°C for 48 hours followed by gradual rewarming over 72 hours
• C Any temperature between 30–38°C as no benefit is proven for temperature control
• D 36–37.5°C (normothermia), avoiding hyperthermia — based on TTM2 trial evidence ✓

Explanation

The TTM2 trial (NEJM 2021) enrolled 1861 OHCA patients and found no significant difference in 6-month mortality or neurological outcome between targeted hypothermia (33°C) and normothermia (37.5°C with fever prevention). Current guidelines (2021 AHA/ILCOR) recommend targeting a constant temperature of 32–37.5°C (any value within this range) for at least 24 hours, with strict avoidance of fever (>37.7°C) which is independently harmful. The strict 32–34°C protocol from earlier trials is no longer mandated, though centres may still target it. Fever prevention remains the core principle.

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

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Written and medically reviewed by the StethoPrep medical team.