Relationship between cooling time and neurological outcomes in targeted temperature management

Abstract

Out-of-hospital cardiac arrest (OHCA) is a global public health problem. 1 In patients who are resuscitated from OHCA, hypoxic brain injury is an important cause of morbidity and mortality. [2][3][4] Targeted temperature management (TTM) ameliorates hypoxic brain damage after OHCA. 5,6 Currently, TTM is the standard treatment for postresuscitated patients. However, it is unclear whether the cooling time (CT) in TTM is a time-sensitive issue. Several studies have shown that early achievement of the target temperature is associated with a favorable neurological prognosis. 7-10 However, other studies have found that reaching the target temperature too quickly increases mortality. [11][12][13] In a recent study comparing targeted hypothermia at 33°C and targeted normothermia at 37.5°C, there was no significant difference