Questions Remain about Targeted Temperature Management in Cardiac Arrest.

For decades, targeted temperature management (TTM) has been a promising intervention for mitigating brain damage after cardiac arrest. Early landmark studies of TTM for out-of-hospital cardiac arrests (OHCAs) with shockable rhythms showed benefits in mortality and neurologic outcome.1,2 On the basis of these results, TTM was established as standard practice and was given a class I recommendation in the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care for use in OHCA with initial shockable rhythms, as well as a class IIb recommendation in patients with initial nonshockable rhythms and for in-hospital cardiac arrests (IHCAs).3.