🌡️ 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.
Post-Cardiac-Arrest Temperature Management (TTM)
Neurologic status after ROSC
Spontaneous temperature
When to use
Use after ROSC to decide whether to implement deliberate temperature control and to set target, duration, and rewarming parameters.
How it works
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.
Key points
- 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.
References
- Dankiewicz J, et al. TTM2 trial. N Engl J Med 2021.
- AHA 2023 focused update on ALS. Circulation 2024.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.