On the Shoulders of Giants
Clay Smith, MD, Twitter
Do not refrigerate
This was a multicenter, international RCT with 950 unconscious post-arrest patients who had targeted temperature management to a goal of 33°C or 36°C. There was no statistical difference between the groups in neurological outcome or survival. This trial helped clarify that what mattered most in regard to post-arrest temperature management was avoidance of hyperthermia. Since 36°C is closer to physiologic and there is no advantage to a lower temperature, this has become the preferred target temperature goal.
Targeted temperature management, with a goal of 36°C in unconscious post-arrest patients, appeared to be as effective as the more aggressive target of 33°C.
Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med. 2013 Dec 5;369(23):2197-206. doi: 10.1056/NEJMoa1310519. Epub 2013 Nov 17.
- Chris Nickson wrote this outstanding summary for LiTFL.
- EMCrit gets way into the weeds on this article with this amazing post and podcast.
Peer Reviewed by:
Thomas Davis, MD, Twitter