Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm

Abstract

Current guidelines from the International Liaison Committee on Resuscitation (ILCOR) recommends that all patients with coma after successful resuscitation from cardiac arrest undergo targeted temperature management with moderate therapeutic hypothermia. However, some studies showed that these interventions had inconclusive effects, especially in patients who are presenting in cardiac arrest with non-shockable rhythms. These patients historically have poorer neurological outcomes compared to patients who present in cardiac arrest with shockable rhythms. With an equal number of studies showing benefit, harm, and no effect, and an increasing number of patients presenting in cardiac arrest with nonshockable rhythms, this study aims to identify whether or not therapeutic hypothermia provides benefit to this patient population. The objective of this study was to assess if therapeutic hypothermia at 33°C versus targeted normothermia improved neurological outcomes at 90 days in coma patients, specifically in those who were successfully resuscitated from nonshockable rhythms.