Macken: Targeted Temperature Management After Out of Hospital Cardiac Arrest
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Transcript of Macken: Targeted Temperature Management After Out of Hospital Cardiac Arrest
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TARGETED TEMPERATURE MANAGEMENT IN
OUT OF HOSPITAL CARDIAC ARREST
Lewis Macken
ICU
RNS
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Post-cardiac arrest syndrome with coma.
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TTM ?
Critical Care Med 2011
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How does TTM work?
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2012
RR 1.55RR 1.35
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Available evidence
77 + 275 = 352
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2010
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Thrombolysis in AMI trials
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330C for 12 hours
77 patients included
1ary outcome = survival to hospital discharge
home or rehabilitation facility = ‘good’ outcome
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OR 5, 1.4-18.7
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32-340C for 24 hours
275 patients
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HACA
RR 1.4 RR 0.75
1.No active temperature control
2.Early stopping
3.8% of OOHCA
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OR 2.2
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“milder levels of hypothermia might have similar protective effects”
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Dose of hypothermia ?
77 for 12 hours @ 33oC 275 for 24 hours @ 32-34oC
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Target temperature management
after out-of-hospital cardiac arrest
The TTM-trial
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TTM Trial
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Temperature profile
HACA-trial 2002
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