. 2025 May;69(5):e70034.

doi: 10.1111/aas.70034.

Fever management with or without a temperature control device after out-of-hospital cardiac arrest and resuscitation (TEMP-CARE): A study protocol for a randomized clinical trial

Johan Holgersson^{1

2}, V Niemelä³, M B Skrifvars³, C Kamp-Jorgensen^{4

5}, M Saxena^{4

6}, P Young^{7

8

9

10}, F Bass^{11

12}, J Dankiewicz¹³, N Hammond¹⁴, J Hästbacka¹⁵, H Levin^{16

17}, G Lilja^{18

19}, M Moseby-Knappe^{16

20}, M Tiainen²¹, M Reinikainen^{22

23}, A Ceric²⁴, J Düring²⁴, A Lybeck²⁵, D Rodriguez-Santos²⁶, J Johnsson²⁷, J Unden^{28

29}, A Lundin³⁰, J Kåhlin^{31

32}, J Grip^{33

34}, J Rosell³⁵, E M Lotman³⁶, L Navarra⁸, B Crichton⁸, D Knight³⁷, A Williams³⁸, L Romundstad^{39

40}, P Seidel⁴¹, P Stammet^{42

43}, T Graf⁴⁴, A Mengel^{45

46}, C Leithner⁴⁷, J Nee⁴⁸, P Druwé⁴⁹, K Ameloot⁵⁰, M Wise⁵¹, J Riddel⁵¹, M Ahmed⁵², M Buckel^{53

54}, P Mc Guigan^{55

56}, R Maharaj⁵⁷, D Wyncoll⁵⁸, M Thomas⁵⁹, J White⁶⁰, T R Keeble^{61

62}, D Pogson⁶³, A Nichol^{9

64

65}, M Haenggi⁶⁶, M P Hilty⁶⁶, M Iten⁶⁷, C Schrag⁶⁸, M Nafi⁶⁹, M Joannidis⁷⁰, C Robba^{71

72}, T Pellis⁷³, J Belohlavek^{74

75

76}, O Smid⁷⁷, D Rob⁷⁸, Y Arabi⁷⁹, S Buabbas⁸⁰, C Yew Woon^{81

82

83}, A Aneman^{84

85

86}, A Stewart⁸⁴, S Bernard⁶⁵, C Palmer-Simpson¹¹, N Simpson¹¹, M Ramanan^{87

88

89}, M Reade⁹⁰, A Delaney^{14

91

92}, B Venkatesh¹¹, J Tirkkonen⁹³, T Oksanen⁹⁴, T Kaakinen^{95

96}, S Bendel⁹⁷, H Friberg^{98

99}, T Cronberg^{18

19}, J Jakobsen^{5

100}, N Nielsen^{1

2}

Affiliations

¹ Department of Clinical Sciences Lund, Anesthesia and Intensive Care, Lund University, Lund, Sweden.
² Department of Anesthesia and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden.
³ Department of Anaesthesia and Intensive Care, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
⁴ Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
⁵ Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
⁶ Critical Care Division and Department of Intensive Care Medicine, The George Institute for Global Health and St George Hospital Clinical School, University of New South Wales, Sydney, Australia.
⁷ Intensive Care Unit, Wellington Hospital, Wellington, New Zealand.
⁸ Medical Research Institute of New Zealand, Wellington, New Zealand.
⁹ Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
¹⁰ Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.
¹¹ Critical Care Program, The George Institute for Global Health, Sydney, Australia.
¹² Royal North Shore Hospital, Sydney, Australia.
¹³ Department of Clinical Sciences Lund, Section of Cardiology, Skåne University Hospital, Malmö, Sweden.
¹⁴ Critical Care Program, The George Institute for Global Health, UNSW, Sydney, Australia.
¹⁵ Wellbeing Services County of Pirkanmaa and Tampere University, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere, Finland.
¹⁶ Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
¹⁷ Department of Research, Development, Education and Innovation, Skåne University Hospital, Lund, Sweden.
¹⁸ Department of Neurology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
¹⁹ Department of Neurology, Skåne University Hospital, Lund, Sweden.
²⁰ Department of Neurology and Rehabilitation, Skåne University Hospital, Lund, Sweden.
²¹ Department of Neurology, Helsinki University Hospital and University of Helsinki, Finland.
²² University of Eastern Finland, Institute of Clinical Medicine.
²³ Department of Anaesthesiology and Intensive Care, Kuopio University Hospital.
²⁴ Anesthesia and Intensive Care, Department of Clinical Sciences, Lund University, Skane University Hospital, Malmö, Sweden.
²⁵ Anesthesia and Intensive Care, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden.
²⁶ Department of Anaesthesia and Intensive Care, Skaraborgs Sjukhus Skövde, Skaraborg, Sweden.
²⁷ Department of Anaesthesiology and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden.
²⁸ Department of Anaesthesiology and Intensive Care, Hallands Hospital Halmstad, Halmstad, Sweden.
²⁹ Department of Intensive and Perioperative Care, Skåne University Hospital, Lund University, Lund, Sweden.
³⁰ Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
³¹ Perioperative Medicine and Intensive Care (PMI), Karolinska University Hospital, Stockholm, Sweden.
³² Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden.
³³ Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
³⁴ Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
³⁵ Department of Anaesthesia and Intensive Care, Central Hospital, Karlstad, Sweden.
³⁶ North Estonia Medical Centre, Tallinn, Estonia.
³⁷ Department of Intensive Care, Christchurch Hospital, Christchurch, New Zealand.
³⁸ Middlemore Hospital, Auckland, New Zealand.
³⁹ Department of Anesthesia and Intensive Care Medicine, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
⁴⁰ Department of Anaesthesia and Intensive Care Medicine, Lovisenberg Diaconal University College, Oslo, Norway.
⁴¹ Department of Intensive Care Medicine, Stavanger University Hospital, Stavanger, Norway.
⁴² Department of Anaesthesia and Intensive Care Medicine, Centre Hospitalier de Luxembourg, Rollingergrund, Luxembourg.
⁴³ Department of Life Sciences and Medicine, Faculty of Science, Technology and Medicine, University of Luxembourg, Luxembourg City Esch-sur-Alzette, Luxembourg.
⁴⁴ University Heart Center Lübeck, University Hospital Schleswig-Holstein, Lübeck, Germany.
⁴⁵ Department of Neurology and Stroke, University Hospital Tuebingen, Tübingen, Germany.
⁴⁶ Department of Neurology and Stroke, Hertie Institute of Clinical Brain Research, Tübingen, Germany.
⁴⁷ Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
⁴⁸ Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Berlin, Germany.
⁴⁹ Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium.
⁵⁰ Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
⁵¹ Adult Critical Care, University Hospital of Wales, Cardiff, UK.
⁵² St George's Hospital, London, UK.
⁵³ Critical Care and Perioperative Medicine Group, Queen Mary University of London, London, UK.
⁵⁴ Department of Perioperative Medicine, Bart's Heart Centre, St. Bartholomew's Hospital, London, UK.
⁵⁵ Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK.
⁵⁶ Regional Intensive Care Unit, Royal Victoria Hospital, Belfast, UK.
⁵⁷ Department of Critical Care Medicine, King's College Hospital, London, UK.
⁵⁸ Guy's & St Thomas' NHS Trust, London, UK.
⁵⁹ Intensive Care Unit, University Hospitals Bristol and Weston, Bristol.
⁶⁰ CEDAR (Centre for Healthcare Evaluation Device Assessment and Research), Cardiff and Vale University Health Board, Cardiff, UK.
⁶¹ Essex Cardiothoracic Centre, MSE NHSFT, Essex, UK.
⁶² Anglia Ruskin School of Medicine & MTRC, Essex, UK.
⁶³ Department of Critical Care, Portsmouth University Hospitals Trust, Portsmouth, UK.
⁶⁴ University College Dublin Clinical Research Centre at St Vincent's University Hospital, University College Dublin, Dublin, Ireland.
⁶⁵ The Alfred Hospital, Melbourne, Australia.
⁶⁶ Institute of Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland.
⁶⁷ Department of Intensive Care Medicine, Inselspital University Hospital Bern, Bern, Switzerland.
⁶⁸ Klinik für Intensivmedizin, Kantonsspital St. Gallen, St. Gallen, Switzerland.
⁶⁹ Istituto Cardiocentro Ticino Lugano, Lugano, Switzerland.
⁷⁰ Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Insbruck, Innsbruck, Austria.
⁷¹ Dipartimento di Scienze Chirurgiche Diagnostiche Integrate, IRCCS Policlinico San Martino, University of Genova, Genova, Italy.
⁷² Dipartimento di Scienze Chirurgiche Diagnostiche Integrate, University of Genova, Genova, Italy.
⁷³ Anaesthesia and Intensive Care, Pordenone Hospital, Azienda Sanitaria Friuli Occidentale, Pordenone, Italy.
⁷⁴ Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
⁷⁵ Department of Internal Medicine, Cardiovascular Medicine, General University Hospital, Prague, Czech Republic.
⁷⁶ Institute for Heart Diseases, Wroclaw Medical University, Wrocław, Poland.
⁷⁷ Department of Internal Medicine, Cardiology and Angiology, General University Hospital in Prague, Prague, Czech Republic.
⁷⁸ Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
⁷⁹ Department of Intensive Care, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
⁸⁰ Department of Anesthesia, Critical Care and Pain Medicine, Jaber Alahmad Alsabah Hospital, Zahra, Kuwait.
⁸¹ Tan Tock Seng Hospital, Singapore.
⁸² Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
⁸³ Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
⁸⁴ Intensive Care Unit, Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia.
⁸⁵ South Western Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
⁸⁶ Department of Clinical Sciences, The Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.
⁸⁷ Caboolture and Royal Brisbane and Women's Hospitals, Metro North Hospital and Health Service, Brisbane, Queensland, Australia.
⁸⁸ School of Clinical Medicine, Queensland University of Technology, Brisbane, Queensland, Australia.
⁸⁹ Critical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
⁹⁰ Medical School, University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, Australia.
⁹¹ Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia.
⁹² Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.
⁹³ Intensive Care Unit, Tampere University Hospital, Tampere, Finland.
⁹⁴ HUS Jorvi Hospital ICU, Esbo, Finland.
⁹⁵ Research Unit of Translational Medicine, Research Group of Anaesthesiology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
⁹⁶ OYS Heart, Oulu University Hospital, MRC Oulu and University of Oulu, Oulu, Finland.
⁹⁷ Department of Intensive Care, Kuopio University Hospitals, Kuopio, Finland.
⁹⁸ Anesthesia and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
⁹⁹ Intensive and Perioperative Care, Skåne University Hospital, Malmö, Sweden.
¹⁰⁰ Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

PMID: 40222389
PMCID: PMC11994252
DOI: 10.1111/aas.70034

Fever management with or without a temperature control device after out-of-hospital cardiac arrest and resuscitation (TEMP-CARE): A study protocol for a randomized clinical trial

Johan Holgersson et al. Acta Anaesthesiol Scand. 2025 May.

. 2025 May;69(5):e70034.

doi: 10.1111/aas.70034.

Authors

Affiliations

¹ Department of Clinical Sciences Lund, Anesthesia and Intensive Care, Lund University, Lund, Sweden.
² Department of Anesthesia and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden.
³ Department of Anaesthesia and Intensive Care, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
⁴ Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
⁵ Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
⁶ Critical Care Division and Department of Intensive Care Medicine, The George Institute for Global Health and St George Hospital Clinical School, University of New South Wales, Sydney, Australia.
⁷ Intensive Care Unit, Wellington Hospital, Wellington, New Zealand.
⁸ Medical Research Institute of New Zealand, Wellington, New Zealand.
⁹ Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
¹⁰ Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.
¹¹ Critical Care Program, The George Institute for Global Health, Sydney, Australia.
¹² Royal North Shore Hospital, Sydney, Australia.
¹³ Department of Clinical Sciences Lund, Section of Cardiology, Skåne University Hospital, Malmö, Sweden.
¹⁴ Critical Care Program, The George Institute for Global Health, UNSW, Sydney, Australia.
¹⁵ Wellbeing Services County of Pirkanmaa and Tampere University, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere, Finland.
¹⁶ Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
¹⁷ Department of Research, Development, Education and Innovation, Skåne University Hospital, Lund, Sweden.
¹⁸ Department of Neurology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
¹⁹ Department of Neurology, Skåne University Hospital, Lund, Sweden.
²⁰ Department of Neurology and Rehabilitation, Skåne University Hospital, Lund, Sweden.
²¹ Department of Neurology, Helsinki University Hospital and University of Helsinki, Finland.
²² University of Eastern Finland, Institute of Clinical Medicine.
²³ Department of Anaesthesiology and Intensive Care, Kuopio University Hospital.
²⁴ Anesthesia and Intensive Care, Department of Clinical Sciences, Lund University, Skane University Hospital, Malmö, Sweden.
²⁵ Anesthesia and Intensive Care, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden.
²⁶ Department of Anaesthesia and Intensive Care, Skaraborgs Sjukhus Skövde, Skaraborg, Sweden.
²⁷ Department of Anaesthesiology and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden.
²⁸ Department of Anaesthesiology and Intensive Care, Hallands Hospital Halmstad, Halmstad, Sweden.
²⁹ Department of Intensive and Perioperative Care, Skåne University Hospital, Lund University, Lund, Sweden.
³⁰ Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
³¹ Perioperative Medicine and Intensive Care (PMI), Karolinska University Hospital, Stockholm, Sweden.
³² Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Sweden.
³³ Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
³⁴ Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
³⁵ Department of Anaesthesia and Intensive Care, Central Hospital, Karlstad, Sweden.
³⁶ North Estonia Medical Centre, Tallinn, Estonia.
³⁷ Department of Intensive Care, Christchurch Hospital, Christchurch, New Zealand.
³⁸ Middlemore Hospital, Auckland, New Zealand.
³⁹ Department of Anesthesia and Intensive Care Medicine, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
⁴⁰ Department of Anaesthesia and Intensive Care Medicine, Lovisenberg Diaconal University College, Oslo, Norway.
⁴¹ Department of Intensive Care Medicine, Stavanger University Hospital, Stavanger, Norway.
⁴² Department of Anaesthesia and Intensive Care Medicine, Centre Hospitalier de Luxembourg, Rollingergrund, Luxembourg.
⁴³ Department of Life Sciences and Medicine, Faculty of Science, Technology and Medicine, University of Luxembourg, Luxembourg City Esch-sur-Alzette, Luxembourg.
⁴⁴ University Heart Center Lübeck, University Hospital Schleswig-Holstein, Lübeck, Germany.
⁴⁵ Department of Neurology and Stroke, University Hospital Tuebingen, Tübingen, Germany.
⁴⁶ Department of Neurology and Stroke, Hertie Institute of Clinical Brain Research, Tübingen, Germany.
⁴⁷ Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
⁴⁸ Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Berlin, Germany.
⁴⁹ Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium.
⁵⁰ Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
⁵¹ Adult Critical Care, University Hospital of Wales, Cardiff, UK.
⁵² St George's Hospital, London, UK.
⁵³ Critical Care and Perioperative Medicine Group, Queen Mary University of London, London, UK.
⁵⁴ Department of Perioperative Medicine, Bart's Heart Centre, St. Bartholomew's Hospital, London, UK.
⁵⁵ Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK.
⁵⁶ Regional Intensive Care Unit, Royal Victoria Hospital, Belfast, UK.
⁵⁷ Department of Critical Care Medicine, King's College Hospital, London, UK.
⁵⁸ Guy's & St Thomas' NHS Trust, London, UK.
⁵⁹ Intensive Care Unit, University Hospitals Bristol and Weston, Bristol.
⁶⁰ CEDAR (Centre for Healthcare Evaluation Device Assessment and Research), Cardiff and Vale University Health Board, Cardiff, UK.
⁶¹ Essex Cardiothoracic Centre, MSE NHSFT, Essex, UK.
⁶² Anglia Ruskin School of Medicine & MTRC, Essex, UK.
⁶³ Department of Critical Care, Portsmouth University Hospitals Trust, Portsmouth, UK.
⁶⁴ University College Dublin Clinical Research Centre at St Vincent's University Hospital, University College Dublin, Dublin, Ireland.
⁶⁵ The Alfred Hospital, Melbourne, Australia.
⁶⁶ Institute of Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland.
⁶⁷ Department of Intensive Care Medicine, Inselspital University Hospital Bern, Bern, Switzerland.
⁶⁸ Klinik für Intensivmedizin, Kantonsspital St. Gallen, St. Gallen, Switzerland.
⁶⁹ Istituto Cardiocentro Ticino Lugano, Lugano, Switzerland.
⁷⁰ Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Insbruck, Innsbruck, Austria.
⁷¹ Dipartimento di Scienze Chirurgiche Diagnostiche Integrate, IRCCS Policlinico San Martino, University of Genova, Genova, Italy.
⁷² Dipartimento di Scienze Chirurgiche Diagnostiche Integrate, University of Genova, Genova, Italy.
⁷³ Anaesthesia and Intensive Care, Pordenone Hospital, Azienda Sanitaria Friuli Occidentale, Pordenone, Italy.
⁷⁴ Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
⁷⁵ Department of Internal Medicine, Cardiovascular Medicine, General University Hospital, Prague, Czech Republic.
⁷⁶ Institute for Heart Diseases, Wroclaw Medical University, Wrocław, Poland.
⁷⁷ Department of Internal Medicine, Cardiology and Angiology, General University Hospital in Prague, Prague, Czech Republic.
⁷⁸ Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
⁷⁹ Department of Intensive Care, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
⁸⁰ Department of Anesthesia, Critical Care and Pain Medicine, Jaber Alahmad Alsabah Hospital, Zahra, Kuwait.
⁸¹ Tan Tock Seng Hospital, Singapore.
⁸² Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
⁸³ Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
⁸⁴ Intensive Care Unit, Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia.
⁸⁵ South Western Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
⁸⁶ Department of Clinical Sciences, The Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.
⁸⁷ Caboolture and Royal Brisbane and Women's Hospitals, Metro North Hospital and Health Service, Brisbane, Queensland, Australia.
⁸⁸ School of Clinical Medicine, Queensland University of Technology, Brisbane, Queensland, Australia.
⁸⁹ Critical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
⁹⁰ Medical School, University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, Australia.
⁹¹ Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia.
⁹² Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.
⁹³ Intensive Care Unit, Tampere University Hospital, Tampere, Finland.
⁹⁴ HUS Jorvi Hospital ICU, Esbo, Finland.
⁹⁵ Research Unit of Translational Medicine, Research Group of Anaesthesiology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
⁹⁶ OYS Heart, Oulu University Hospital, MRC Oulu and University of Oulu, Oulu, Finland.
⁹⁷ Department of Intensive Care, Kuopio University Hospitals, Kuopio, Finland.
⁹⁸ Anesthesia and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
⁹⁹ Intensive and Perioperative Care, Skåne University Hospital, Malmö, Sweden.
¹⁰⁰ Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

PMID: 40222389
PMCID: PMC11994252
DOI: 10.1111/aas.70034

Abstract

Background: Fever is associated with brain injury after cardiac arrest. It is unknown whether fever management with a feedback-controlled device impacts patient-centered outcomes in cardiac arrest patients. This trial aims to investigate fever management with or without a temperature control device after out-of-hospital cardiac arrest.

Methods: The TEMP-CARE trial is part of the 2 × 2 × 2 factorial Sedation, TEmperature and Pressure after Cardiac Arrest and REsuscitation (STEPCARE) trial, a randomized, international, multicenter, parallel-group, investigator-initiated, superiority trial that will evaluate sedation strategies, temperature management, and blood pressure targets simultaneously in nontraumatic/nonhemorrhagic out-of-hospital cardiac arrest patients following hospital admission. For the temperature management component of the trial described in this protocol, patients will be randomly allocated to fever management with or without a feedback-controlled temperature control device. For those managed with a device, if temperature ≥37.8°C occurs within 72 h post-randomization the device will be started targeting a temperature of ≤37.5°C. Standard fever treatment, as recommended by local guidelines, including pharmacological agents, will be provided to participants in both groups. The two other components of the STEPCARE trial evaluate sedation and blood pressure strategies. Apart from the STEPCARE trial interventions, all other aspects of general intensive care will be according to the local practices of the participating site. A physician blinded to the intervention will determine the neurological prognosis following European Resuscitation Council and European Society of Intensive Care Medicine guidelines. The primary outcome is all-cause mortality at six months post-randomization. To detect a 5.6% absolute risk reduction (90% power, alpha .05), 3500 participants will be enrolled. Secondary outcomes include poor functional outcome at six months, intensive care-related serious adverse events, and overall health status at six months.

Conclusion: The TEMP-CARE trial will investigate if post-cardiac arrest management of fever with or without a temperature control device affects patient-important outcomes after cardiac arrest.

Keywords: cardiac arrest; feedback‐controlled device; fever; randomized controlled trial; temperature management.

PubMed Disclaimer

Conflict of interest statement

Skrifvars MB received a speakers fee from BARD Medical (Ireland) 2022 and is a member of the editorial board of Acta Anaesthesiologica Scandinavica. Leithner C has received research support from the Laerdal Foundation. Nee J received honorarium and travel costs for presentations from BD BARD and Xenios AG. Joannidis M has received consulting fees from Baxter Healthcare Corp, AM‐Phjarma, Biomerieux, Sphingotec and AOP pharma, and honoraria for lectures from Baxter Healthcare Corp, AOP Health and Biomerieux, and grants from Baxter Healthcare and Fresenius. Pellis T has received lecture fees from BD. Reade M is an investigator in several National Health and Medical Research Council—funded trials, including trials of sedative agents and other treatments for brain injury.

Cited by

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Long-Term Outcomes After Cardiac Arrest: Protocol for the Extended Follow-Up Sub-Study of the STEPCARE Trial.
Lilja G, Töniste D, Bass F, Jakobsen JC, Nielsen N, Skrifvars MB, Ullén S, Dankiewicz J, Levin H, Hästbacka J, Knappe MM, Saxena M, Wise MP, Young P, Aneman A, Ameloot K, Cole JM, Cronberg T, Delaney A, Druwé P, During J, Graf T, Haenggi M, Heimburg K, Itens M, Barkholt CK, Keeble TR, Leithner C, Lybeck A, Lundin A, McGuigan P, Mengel A, Oksanen T, Ridgway J, Romundstad L, Schrag C, Stammet P, Tippett A, Thomas M, Tirkkonen J, Undén J, Venkatesh B, Tiainen M, Hammond N. Lilja G, et al. Acta Anaesthesiol Scand. 2025 Oct;69(9):e70114. doi: 10.1111/aas.70114. Acta Anaesthesiol Scand. 2025. PMID: 40856035 Free PMC article.

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Fever management with or without a temperature control device after out-of-hospital cardiac arrest and resuscitation (TEMP-CARE): A study protocol for a randomized clinical trial

Affiliations

Fever management with or without a temperature control device after out-of-hospital cardiac arrest and resuscitation (TEMP-CARE): A study protocol for a randomized clinical trial

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