What temperature target is recommended after cardiac arrest?

TTM-2 trial: TTM at 33°C vs 36°C showed no difference in survival or neurological outcome; current guideline (ERC 2021): prevent fever (temperature >37.7°C) for at least 72h in comatose survivors; active cooling to 32-34°C for initial 24h may benefit some patients.

What rewarming rate is recommended after TTM?

Rewarming at 0.25-0.5°C/hour prevents electrolyte disturbances (K+ rises as cells return to normal) and hemodynamic instability; rapid rewarming associated with worse neurological outcomes; maintain normothermia after TTM for minimum 48-72h to prevent fever rebound.

When is neuroprognostication performed after cardiac arrest?

Prognostication deferred until ≥72h after arrest (or rewarming completion if TTM used); multimodal approach: clinical exam (absent pupillary/corneal reflexes), EEG (burst suppression, status epilepticus), SSEP (absent bilateral N20), CT/MRI brain, and serum NSE.

What hemodynamic targets are maintained during TTM?

MAP ≥65-70 mmHg (higher if chronic hypertension); avoiding MAP <65 mmHg critical as post-arrest myocardial stunning reduces cardiac output; SpO2 94-98% (hyperoxia associated with worse outcomes in some studies); glucose 5-10 mmol/L.

What EEG patterns predict poor outcome after cardiac arrest?

Suppression-burst pattern at 24h: poor prognosis; absence of EEG reactivity at 24-48h: poor prognosis; diffuse continuous suppression; status epilepticus post-cardiac arrest has poor prognosis; continuous EEG monitoring recommended for 24-48h post-arrest.

Targeted Temperature Management (TTM) Protocol Post-Cardiac Arrest

Calculates TTM target temperature (33-36°C), rewarming rate (0.25°C/hour), hemodynamic targets during cooling, and EEG/neurology outcome prediction using post-arrest NIHSS equivalent assessment.

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Frequently Asked Questions

What temperature target is recommended after cardiac arrest?

What rewarming rate is recommended after TTM?

When is neuroprognostication performed after cardiac arrest?

What hemodynamic targets are maintained during TTM?

What EEG patterns predict poor outcome after cardiac arrest?