Articles

This collection of articles represents some of the leading science in resuscitation and post-arrest care. Questions regarding these articles should be directed to the authors. If you feel we have missed an important article, please send us an email at ttmTraining@pennmedicine.upenn.edu.

Post-arrest TTM RCTs

Hypothermia versus Normothermia After Out-of-Hospital Cardiac Arrest

June 17, 2021The New England Journal of Medicine

Dankiewicz et al. (TTM2 Trial Investigators)

In an open-label randomized controlled trial with blinded assessment of outcomes, 1900 adults with coma who had had an out-of-hospital cardiac arrest of presumed cardiac or unknown cause were randomized to undergo targeted hypothermia at 33°C, followed by controlled rewarming, or targeted normothermia with early treatment of fever (body temperature, ≥37.8°C).

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Targeted temperature management for cardiac arrest with nonshockable rhythm.

December 12, 2019 • The New England Journal of Medicine 

Lascarrou JB et al.

Randomized controlled trial of hypothermia at 33 °C vs. normothermia (37 °C) in comatose patients with coma who had been admitted to the intensive care unit (ICU) after resuscitation from cardiac arrest with nonshockable rhythm.

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Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest: The PRINCESS Randomized Clinical Trial.

May 7, 2019 • JAMA Network

 Nordberg P et al.

International, multicenter, randomized controlled trial of patients who experienced out-of-hospital cardiac arrest.  Randomized to receive intra-nasal evaporative intra-arrest cooling versus standard care.  Both groups received systemic therapeutic hypothermia to 32 °C to 34 °C.

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Targeted temperature management for 48 vs 24 hours and neurologic outcome after out-of-hospital cardiac arrest

July 25, 2017 • JAMA Network 

Kirkegaard et al.

Randomized controlled trial of 24h vs. 48h of hypothermia to 33 °C in adults with out-of-hospital cardiac arrest.

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Targeted temperature management at 33°C versus 36°C after cardiac arrest.

December 5, 2013 • The New England Journal of Medicine 

Nielsen N et al.

Randomized controlled trial comparing two different target temperatures of hypothermia: 33 °C and 36 °C. Enrolled patients with out-of-hospital cardiac arrest of presumed cardiac cause.

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Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia

February 21, 2002 • New England Journal of Medicine 

Bernard SA et al.

Small randomized controlled trial of patients with out-of-hospital cardiac arrest with ventricular fibrillation as the presenting rhythm. Randomized to hypothermia to 33 °C vs. no targeted temperature management.

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Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest 

February 21, 2002 • New England Journal of Medicine 

Hypothermia After Cardiac Arrest Study Group

Multicenter randomized controlled trial of patients who had been resuscitated after cardiac arrest due to ventricular fibrillation.  Randomized to hypothermia to 32-34 °C over a period of 24 hours vs. standard treatment with normothermia.

Expert Commentary

PODCAST: EMCrit 307 – TTM2 Episode Retort with Ben Abella & Joe Tonna

September 23, 2021 by Scott Weingart, MD FCCM