No Benefit of Targeted Temperature Management for In-Hospital Cardiac Arrest

Targeted temperature management (TTM), i.e., therapeutic hypothermia, was shown to be beneficial for out-of-hospital cardiac arrest (OHCA) in studies published 20 years ago. However, subsequent larger randomized, controlled trials failed to show a benefit of TTM compared with just preventing fever (NEJM JW Emerg Med Jan 2014 and N Engl J Med 2013; 369:2197; NEJM JW Gen Med Aug 1 2021 and N Engl J Med 2021; 384:2283). To date, no trials of TTM have been performed exclusively in survivors of in-hospital cardiac arrest (IHCA).

In this large randomized, controlled trial conducted in Germany (NCT00457431), 249 patients successfully resuscitated and unconscious for >45 minutes after IHCA were assigned to receive cooling to temperatures of 32–34 de…