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Comment
. 2020 Jan 6;24(1):6.
doi: 10.1186/s13054-019-2721-1.

High Quality Targeted Temperature Management (TTM) After Cardiac Arrest

Fabio Silvio Taccone  1 , Edoardo Picetti  2 , Jean-Louis Vincent  3
Affiliations
Comment

High Quality Targeted Temperature Management (TTM) After Cardiac Arrest

Fabio Silvio Taccone et al. Crit Care. .

Abstract

Targeted temperature management (TTM) is a complex intervention used with the aim of minimizing post-anoxic injury and improving neurological outcome after cardiac arrest. There is large variability in the devices used to achieve cooling and in protocols (e.g., for induction, target temperature, maintenance, rewarming, sedation, management of post-TTM fever). This variability can explain the limited benefits of TTM that have sometimes been reported. We therefore propose the concept of "high-quality TTM" as a way to increase the effectiveness of TTM and standardize its use in future interventional studies.

Keywords: Cardiac arrest; Outcome; Quality; Temperature.

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Conflict of interest statement

FST received lecture fees from BD and ZOLL. EP received lecture fees from BD. JLV declares that there are no competing interests.

Figures

Fig. 1
Fig. 1
Different approaches to providing targeted temperature management (TTM), regardless of its quality, in five hypothetical patients admitted after successfully resuscitated cardiac arrest. Colors identify different patients and do not refer to quality of TTM
Fig. 2
Fig. 2
Some of the various factors related to targeted temperature management (TTM) which are relevant to providing “high-quality” TTM
Fig. 3
Fig. 3
Practical representation of “low-quality” (a) and “high-quality” (b) targeted temperature management (TTM) in a patient resuscitated and admitted to the hospital after cardiac arrest. The colors of the screen and temperature time course as of the TTM methods (blankets or external device) are not intended to promote any specific cooling device
See this image and copyright information in PMC

Comment on

  • Targeted temperature management at 33°C versus 36°C after cardiac arrest.
    Nielsen N, Wetterslev J, Cronberg T, Erlinge D, Gasche Y, Hassager C, Horn J, Hovdenes J, Kjaergaard J, Kuiper M, Pellis T, Stammet P, Wanscher M, Wise MP, Åneman A, Al-Subaie N, Boesgaard S, Bro-Jeppesen J, Brunetti I, Bugge JF, Hingston CD, Juffermans NP, Koopmans M, Køber L, Langørgen J, Lilja G, Møller JE, Rundgren M, Rylander C, Smid O, Werer C, Winkel P, Friberg H; TTM Trial Investigators. Nielsen N, et al. N Engl J Med. 2013 Dec 5;369(23):2197-206. doi: 10.1056/NEJMoa1310519. Epub 2013 Nov 17. N Engl J Med. 2013. PMID: 24237006 Clinical Trial.

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