What are the AHA guidelines for targeted temperature management (TTM)?

Updated: Jul 26, 2019
  • Author: Alex Koyfman, MD; Chief Editor: Karlheinz Peter, MD, PhD  more...
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Answer

Answer

The 2015 American Heart Association (AHA) guidelines on TTM can be summarized as follows [2] :

  • Induce hypothermia for unconscious adult patients with return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest when the initial rhythm was ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) (class I, level of evidence: B-R)

  • Similar therapy may be beneficial for patients with non-VF/non-pVT (nonshockable) arrest out-of-hospital or with in-hospital arrest (class I, level of evidence: C-EO)

  • The temperature should be maintained between 32ºC and 36ºC (class I, level of evidence: B-R)

  • It is reasonable to maintain TTM for at least 24 hours (class IIa, level of evidence: C-EO)

  • Routine prehospital cooling of patients with ROSC with intravenous (IV) rapid infusion is not advised (class III: no benefit; level of evidence A)

  • It is reasonable to prevent fever in comatose patients after TTM (class IIb, level of evidence C-LD) 

  • Hemodynamically stable patients with spontaneous mild hypothermia (>33°C) after resuscitation from cardiac arrest should not be actively rewarmed


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