Prolonged Active Fever Management After Out-of-Hospital Cardiac Arrest Showed No Benefit

Guidelines recommend targeted temperature management in the first 24 hours after cardiac arrest for comatose patients (Circulation 2015; 132:2448). In addition, some guidelines recommend actively avoiding fever (i.e., keeping temperature <37.8°C with external cooling devices) for the next 72 hours (Intensive Care Med 2022; 48:261). Trials have been conducted to determine the best target temperature and duration of cooling, but data are limited on active fever management.

Danish investigators randomized nearly 800 comatose patients after out-of-hospital cardiac arrest due to presumed cardiac cause to either 12 or 48 hours of active fever prevention (goal temperature, 37°C). The majority of patients had shockable rhythms. All patients initiall…