ILCOR Paediatric Life Support Task Force Systematic Review and Meta-analysis (2019) : 12 studies included, 2 RCTs and including 2060 patients. Inconclusive evidence to either support or refute the use of TTM at 32-34°C for comatose children who achieve ROSC.
- Of note, this systematic review and meta-analysis helped to inform the ILCOR Consensus on Science with Treatment Recommendations (CoSTR)
References and Links
- Reports of the death of therapeutic hypothermia are greatly exaggerated (2013)
- All in a lather over TTM (2013)
- CCC — ABG changes in Cardiac Arrest and CPR
- CCC — Arterial Blood Gas in Hypothermia
- CCC — Prognosis after cardiac arrest
- CCC — Post-cardiac arrest syndrome
- Arrich J, Holzer M, Herkner H, Müllner M. Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation. Cochrane Database of Systematic Reviews 2009. PMID: 19821320
- Bernard SA, Gray TW, Buist MD et al. Treatment of comatose survivors of out-of -hospital cardiac arrest with induced hypothermia. N Eng J Med 2002;346:557-63 PMID: 11856794 [Free Full Text]
- Bernard SA, Smith K, Cameron P, et al. Induction of therapeutic hypothermia by paramedics after resuscitation from out-of-hospital ventricular fibrillation cardiac arrest, a randomized controlled trial. Circ. 2010; 122:737-42. PMID: 20679551
- Buick JE, Wallner C, Aickin R, Meaney PA, de Caen A, Maconochie I, Skrifvars MB, Welsford M; International Liaison Committee on Resuscitation Pediatric Life Support Task Force. Paediatric targeted temperature management post cardiac arrest: A systematic review and meta-analysis. Resuscitation. 2019 Jun;139:65-75. doi: 10.1016/j.resuscitation.2019.03.038. Epub 2019 Apr 2. PMID: 30951842.
- Dankiewicz J, Cronberg T, Lilja G, Nielsen N, et al; TTM2 Trial Investigators. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest. N Engl J Med. 2021 Jun 17;384(24):2283-2294. doi: 10.1056/NEJMoa2100591. PMID: 34133859. [Free Full Text]
- Hypothermia after cardiac arrest (HACA) study group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Eng J Med 2002;346:549-56. PMID: 11856793 [Free Full Text]
- Nielsen N, Friberg H, Gluud C, Herlitz J, Wetterslev J. Hypothermia after cardiac arrest should be further evaluated–a systematic review of randomised trials with meta-analysis and trial sequential analysis. Int J Cardiol. 2011 Sep 15;151(3):333-41. doi: 10.1016/j.ijcard.2010.06.008. Epub 2010 Jul 1. Review. PubMed PMID: 20591514.
- Nolan JP, Sandroni C, Böttiger BW, Cariou A, Cronberg T, Friberg H, Genbrugge C, Haywood K, Lilja G, Moulaert VRM, Nikolaou N, Olasveengen TM, Skrifvars MB, Taccone F, Soar J. European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care. Intensive Care Med. 2021 Apr;47(4):369-421. doi: 10.1007/s00134-021-06368-4. Epub 2021 Mar 25. PMID: 33765189; PMCID: PMC7993077. [Free Full Text]
- Polderman KH. Mechanisms of action, physiological effects, and complications of hypothermia. Crit Care Med 2009; 37[S]: S186-S202. PMID: 19535947
- Sandroni C, Cavallaro F, Antonelli M. Therapeutic hypothermia: is it effective for non-VF/VT cardiac arrest? Crit Care. 2013 Mar 19;17(2):215. [Epub ahead of print] PubMed PMID: 23510394; PubMed Central PMCID: PMC3672513. [Free Full Text]
- Wassink G, Davidson JO, Lear CA, Juul SE, Northington F, Bennet L, Gunn AJ. A working model for hypothermic neuroprotection. J Physiol. 2018 Dec;596(23):5641-5654. doi: 10.1113/JP274928. Epub 2018 May 24. PMID: 29660115; PMCID: PMC6265568. [Free Full Text]
FOAM and web resources
- Kim, A; Flower, O. Resuscitation After Cardiac Arrest – NeuroResus. Retrieved 26 April 2022, from https://neuroresus.com/lessons/resuscitation-after-cardiac-arrest/.
- Center for Resuscitation Science
- EMCrit — Induced Hypothermia after Cardiac Arrest Lecture
- ICN — SMACC: Macken – Targeted Temperature Management After Out of Hospital Cardiac Arrest (2013)
- ICN — 67. NIELSEN on Therapeutic Hypothermia after Cardiac Arrest (2013)
- Bradford, C. (2022). TTM2 – The Bottom Line. Retrieved 26 April 2022, from https://www.thebottomline.org.uk/summaries/icm/ttm2/.
- Chambler, D. (2014). HACA – The Bottom Line. Retrieved 26 April 2022, from https://www.thebottomline.org.uk/summaries/icm/haca/.
- Chambler, D. (2014). TTM – The Bottom Line. Retrieved 26 April 2022, from https://www.thebottomline.org.uk/summaries/icm/ttm/.
- Olusanya, S. (2019). HYPERION – The Bottom Line. Retrieved 26 April 2022, from https://www.thebottomline.org.uk/summaries/hyperion/.
- Bersten, A. and Soni, N., 2014. Oh’s Intensive Care Manual. 7th ed. Elsevier.
Critical Care
James Pearlman
ICU Advanced Trainee BMedSci [UoN], BMed [UoN], MMed(CritCare) [USyd] from a broadacre farm who found himself in a quaternary metropolitan ICU. Always trying to make medical education more interesting and appropriately targeted; pre-hospital and retrieval curious; passionate about equitable access to healthcare; looking forward to a future life in regional Australia. Student of LITFL.
Chris Nickson
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.