Which Temperature for Targeted Temperature Management After Cardiac Arrest?

In 2002, two landmark randomized, controlled trials showed important benefits of therapeutic hypothermia in patients who achieved return of spontaneous circulation after cardiac arrest (NEJM JW Emerg Med Apr 2002 and N Engl J Med 2002; 346:549 and 557). But in 2013, a large randomized trial showed no benefit of hypothermia (33°C) compared to controlled normothermia (36°C; NEJM JW Emerg Med Jan 2014 and N Engl J Med 2013; 369:2197). To further evaluate the optimal target temperature, investigators reviewed data from a national registry of out-of-hospital cardiac arrests (OHCA) in Japan from 2014 to 2015. The main outcome measure was neurologically favorable survival (cerebral performance category 1 or 2) at 1 month.

Of 13,200 adult patients w…