Post-Cardiac-Arrest Temperature Management (TTM) — free guideline decision tool
Post-cardiac-arrest temperature management: select and maintain a single target temperature for comatose patients and actively prevent fever.
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Implements the decision logic from published clinical guidelines.
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Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Neurologic status after ROSC | Comatose · unable to follow commands |
|---|---|
| Spontaneous temperature | Normal or febrile |
→TTMComatose: start temperature control 32–37.5°C
- Decision point：Implement a deliberate temperature-control strategy for all post-ROSC patients unable to follow commands (regardless of in/out-of-hospital or initial rhythm)
- Target temperature：Select and maintain a single constant temperature between 32–37.5°C (33°C no longer mandatory after TTM2); ≤ 36°C may suit bleeding/intracranial hemorrhage/hemodynamically unstable patients; 33°C may be individually considered for non-shockable rhythms (HYPERION)
- Maintenance duration：Maintain temperature control ≥ 24 h after reaching target (AHA 2025 suggests a total duration ≥ 36 h)
| Neurologic status after ROSC | Awake / can follow commands |
|---|---|
| Spontaneous temperature | Spontaneous mild hypothermia > 33°C |
→TTMFollowing commands: no active cooling needed
- Management：Awake/command-following patients do not need active cooling; continuously monitor core temperature and actively prevent/treat fever (treat > 37.5–37.7°C immediately)
- Etiology：Actively seek and treat the cause of arrest; ACS accounts for ~65% of shockable OHCA, persistent ischemic ECG → emergent coronary angiography/PCI
- Basis：AHA 2023 ALS focused update; 2025 Part 11 post-arrest care
Common questions
What is Post-Cardiac-Arrest Temperature Management (TTM)?
Post-cardiac-arrest temperature management: select and maintain a single target temperature for comatose patients and actively prevent fever.
How is Post-Cardiac-Arrest Temperature Management (TTM) calculated? What is the core formula?
Comatose (cannot follow commands): maintain a single constant temperature 32–37.5°C for ≥ 24 h (total ≥ 36 h), rewarm ≤ 0.25–0.5°C/h, prevent fever ≥ 72 h; command-following: no active cooling, just prevent fever.
When is Post-Cardiac-Arrest Temperature Management (TTM) used?
Use after ROSC to decide whether to implement deliberate temperature control and to set target, duration, and rewarming parameters.
What are the key clinical points for Post-Cardiac-Arrest Temperature Management (TTM)?
After TTM2, 33°C is no longer mandatory — any single target 32–37.5°C with strict fever avoidance is acceptable (original synthesis · not guideline verbatim). Hypothermia does not preclude PCI; pursue coronary reperfusion in parallel. Use core-temperature probes (esophageal/bladder/intravascular), not rectal/oral/axillary, for control.
What are the limits and cautions when using Post-Cardiac-Arrest Temperature Management (TTM)?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is Post-Cardiac-Arrest Temperature Management (TTM) calculated in practice? Can you show a worked example?
Inputs: Neurologic status after ROSC Comatose · unable to follow commands, Spontaneous temperature Normal or febrile → Result: TTM Comatose: start temperature control 32–37.5°C（Decision point: Implement a deliberate temperature-control strategy for all post-ROSC patients unable to follow commands (regardless of in/out-of-hospital or initial rhythm), Target temperature: Select and maintain a single constant temperature between 32–37.5°C (33°C no longer mandatory after TTM2); ≤ 36°C may suit bleeding/intracranial hemorrhage/hemodynamically unstable patients; 33°C may be individually considered for non-shockable rhythms (HYPERION), Maintenance duration: Maintain temperature control ≥ 24 h after reaching target (AHA 2025 suggests a total duration ≥ 36 h)） Inputs: Neurologic status after ROSC Awake / can follow commands, Spontaneous temperature Spontaneous mild hypothermia > 33°C → Result: TTM Following commands: no active cooling needed（Management: Awake/command-following patients do not need active cooling; continuously monitor core temperature and actively prevent/treat fever (treat > 37.5–37.7°C immediately), Etiology: Actively seek and treat the cause of arrest; ACS accounts for ~65% of shockable OHCA, persistent ischemic ECG → emergent coronary angiography/PCI, Basis: AHA 2023 ALS focused update; 2025 Part 11 post-arrest care）
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Post-cardiac-arrest temperature management: select and maintain a single target temperature for comatose patients and actively prevent fever.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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