No Difference in 24 vs. 48 Hours of Targeted Temperature Management After Cardiac Arrest

Current American Heart Association guidelines recommend targeted temperature management for at least 24 hours after cardiac arrest (Circulation 2015; 132:Suppl 2:S465). To determine the optimal duration of cooling, European investigators randomized 355 patients who suffered out-of-hospital arrest to either 24 or 48 hours of targeted temperature management at 33°C. Nearly 90% of the patients had shockable rhythms; 83% received bystander cardiopulmonary resuscitation.

At 6 months, similar numbers of patients (64% of the 24-hour group and 69% of the 48-hour group) had good neurological outcomes. Investigators found no significant difference in mortality (34% and 27%) and comparable frequencies of life-support withdrawal for neurological reasons…