open access

Vol 47, No 2 (2015)
Review articles
Published online: 2014-11-24
Submitted: 2014-07-29
Accepted: 2014-09-30
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From therapeutic hypothermia towards targeted temperature management: a decade of evolution

Pieter-Jan Palmers, Nick Hiltrop, Koen Ameloot, Philippe Timmermans, Bert Ferdinande, Peter Sinnaeve, Rogier Nieuwendijk, Manu L.N.G. Malbrain
DOI: 10.5603/AIT.a2014.0066
·
Anaesthesiol Intensive Ther 2015;47(2):156-161.

open access

Vol 47, No 2 (2015)
Review articles
Published online: 2014-11-24
Submitted: 2014-07-29
Accepted: 2014-09-30

Abstract

More than a decade after the first randomised controlled trials with targeted temperature management (TTM), it remains the only treatment with proven favourable effect on postanoxemic brain damage after out-of-hospital cardiac arrest. Other well-known indications include neurotrauma, subarachnoidal haemorrhage, and intracranial hypertension. When possible pitfalls are taken into consideration when implementing TTM, the side effects are manageable. After the recent TTM trials, it seems that classic TTM (32−34°C) is as effective and safe as TTM at 36°C. This supports the belief that fever prevention is one of the pivotal mechanisms that account for the success of TTM. Uncertainty remains concerning cooling method, timing, speed of cooling and rewarming. New data indicates that TTM is safe and feasible in cardiogenic shock, one of its classic contra-indications. Moreover, there are limited indications that TTM might be considered as a therapy for cardiogenic shock per se.

Abstract

More than a decade after the first randomised controlled trials with targeted temperature management (TTM), it remains the only treatment with proven favourable effect on postanoxemic brain damage after out-of-hospital cardiac arrest. Other well-known indications include neurotrauma, subarachnoidal haemorrhage, and intracranial hypertension. When possible pitfalls are taken into consideration when implementing TTM, the side effects are manageable. After the recent TTM trials, it seems that classic TTM (32−34°C) is as effective and safe as TTM at 36°C. This supports the belief that fever prevention is one of the pivotal mechanisms that account for the success of TTM. Uncertainty remains concerning cooling method, timing, speed of cooling and rewarming. New data indicates that TTM is safe and feasible in cardiogenic shock, one of its classic contra-indications. Moreover, there are limited indications that TTM might be considered as a therapy for cardiogenic shock per se.

Get Citation

Keywords

therapeutic hypothermia, targeted temperature management, cardiogenic shock, cardiac arrest, indications, limitations

About this article
Title

From therapeutic hypothermia towards targeted temperature management: a decade of evolution

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 47, No 2 (2015)

Pages

156-161

Published online

2014-11-24

DOI

10.5603/AIT.a2014.0066

Bibliographic record

Anaesthesiol Intensive Ther 2015;47(2):156-161.

Keywords

therapeutic hypothermia
targeted temperature management
cardiogenic shock
cardiac arrest
indications
limitations

Authors

Pieter-Jan Palmers
Nick Hiltrop
Koen Ameloot
Philippe Timmermans
Bert Ferdinande
Peter Sinnaeve
Rogier Nieuwendijk
Manu L.N.G. Malbrain

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