🌡️ Post-Cardiac-Arrest Temperature Management (TTM)
UseUse after ROSC to decide whether to implement deliberate temperature control and to set target, duration, and…
SourceAHA 2023 focused update on ALS. Circulation 2024.
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
Methodology · worked example, guidelines & full notes
After TTM2, 33°C is no longer mandatory — any single target temperature with strict fever avoidance is acceptable (original synthesis · not guideline verbatim).
When to use
Use after ROSC to decide whether to implement deliberate temperature control and to set target, duration, and rewarming parameters.
How it works
Comatose (cannot follow commands): maintain a single constant target temperature [pending update], control the rewarming rate, prevent fever [pending update]; command-following: no active cooling, just prevent fever.
Key points
- After TTM2, 33°C is no longer mandatory — any single target temperature with strict fever avoidance is acceptable (original synthesis · not guideline verbatim).
- Hypothermia does not preclude PCI; pursue coronary reperfusion in parallel.
- Use core-temperature probes (esophageal/bladder/intravascular), not rectal/oral/axillary, for control.
References
- [Guideline / primary source]AHA 2023 focused update on ALS. Circulation 2024.
- Dankiewicz J, et al. TTM2 trial. N Engl J Med 2021.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Neurologic status after ROSC | Comatose · unable to follow commands |
|---|---|
| Spontaneous temperature | Normal or febrile |
→TTMComatose: start temperature control [pending update]
- Decision point：Implement a deliberate temperature-control strategy for all post-ROSC patients unable to follow commands (regardless of in/out-of-hospital or initial rhythm)
- Target temperature：Select and maintain a single constant target temperature [pending update] (33°C no longer mandatory after TTM2); ≤ 36°C may suit bleeding/intracranial hemorrhage/hemodynamically unstable patients; 33°C may be individually considered for non-shockable rhythms (HYPERION)
- Maintenance duration：Maintain temperature control [pending update] after reaching target (total duration [pending update])
| Neurologic status after ROSC | Awake / can follow commands |
|---|---|
| Spontaneous temperature | Spontaneous mild hypothermia > 33°C |
→TTMFollowing commands: no active cooling needed
- Management：Awake/command-following patients do not need active cooling; continuously monitor core temperature and actively prevent/treat fever (treat > 37.5–37.7°C immediately)
- Etiology：Actively seek and treat the cause of arrest; ACS accounts for ~65% of shockable OHCA, persistent ischemic ECG → emergent coronary angiography/PCI
- Basis：AHA 2023 ALS focused update; 2025 Part 11 post-arrest care
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Post-Cardiac-Arrest Temperature Management (TTM)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Post-Cardiac-Arrest Temperature Management (TTM) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Post-Cardiac-Arrest Temperature Management (TTM) calculated in practice? Can you show a worked example?
- Inputs: Neurologic status after ROSC Comatose · unable to follow commands, Spontaneous temperature Normal or febrile → Result: TTM Comatose: start temperature control [pending update]（Decision point: Implement a deliberate temperature-control strategy for all post-ROSC patients unable to follow commands (regardless of in/out-of-hospital or initial rhythm), Target temperature: Select and maintain a single constant target temperature [pending update] (33°C no longer mandatory after TTM2); ≤ 36°C may suit bleeding/intracranial hemorrhage/hemodynamically unstable patients; 33°C may be individually considered for non-shockable rhythms (HYPERION), Maintenance duration: Maintain temperature control [pending update] after reaching target (total duration [pending update])） Inputs: Neurologic status after ROSC Awake / can follow commands, Spontaneous temperature Spontaneous mild hypothermia > 33°C → Result: TTM Following commands: no active cooling needed（Management: Awake/command-following patients do not need active cooling; continuously monitor core temperature and actively prevent/treat fever (treat > 37.5–37.7°C immediately), Etiology: Actively seek and treat the cause of arrest; ACS accounts for ~65% of shockable OHCA, persistent ischemic ECG → emergent coronary angiography/PCI, Basis: AHA 2023 ALS focused update; 2025 Part 11 post-arrest care）