Thread by @tscquizzato

THREAD and my infographic of the #TTM2 trial

#OHCA patients were randomised to #TTM at 33°C or normothermia (<37.8°C) with early fever treatment.

➡️ Mortality and poor neuro outcome at 6 months were not lower in the hypothermia group.

🔗 nejm.org/doi/full/10.10… #FOAMcc

Guidelines recommend selecting and maintaining a constant target #TTM between 32 and 36 °C in comatose post-cardiac arrest patients to prevent hypoxic-ischemic brain damage.
(strong recommendation, moderate-quality evidence). #FOAMcc

Two RCTs published in 2002 showed an improved survival and neurologic outcome in patients resuscitated from OHCA of presumed cardiac cause and shockable rhythm who underwent hypothermia at 33°C. #FOAMcc

In 2019, @JBLascarrou and colleagues published the #HYPERIONtrial showing that 24h #TTM 33°C vs. targeted normothermia (37°C) improves 90-days neuro outcomes in patients with coma resuscitated from cardiac arrest with nonshockable rhythm. #FOAMcc

https://twitter.com/tscquizzato/status/1179366839740243976?lang=en

RCTs comparing the level of targeted temperature management (#TTM trial, 33°C or 36°C) and the duration of this management (24 hours or 48 hours) have not indicated a dose effect. #FOAMcc

In the just published #TTM2 trial, there was no significant difference between hypothermia and normothermia with respect to death and poor functional outcome at 6 mo.

Article nejm.org/doi/full/10.10…
Editorial nejm.org/doi/full/10.10…

Congrats to @nielsen_niklas et al
#FOAMcc