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.

⚕ Clinical Disclaimer: These calculators are for educational and reference purposes only. Always verify results with qualified clinical judgment and current clinical guidelines. Do not use as a sole basis for medical decisions.

How to Use

Enter the values for the scenario you are assessing. 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. Use the ttm protocol result to inform your calculation.

Related Calculators

SOFA Score

Medical

APACHE II