Cardiac Arrest Care

General Information

Presently, many issues remain unanswered. In particular the optimal duration and target temperature of TTM after resuscitation continues to be unclear. On grounds of new research data it is assumed that the future will lead to an increasingly individual management of TTM for the patients. However it is very difficult to characterize and identify at an early stage the type of patients who can especially benefit from TTM.

Nevertheless it is unquestioned that for every patient after cardiac arrest TTM should be applied in order to improve the outcome.

In the future, research concerning the possible expansion of indications for TTM for various diseases (for example heart attack and liver coma) will be carried out.  Beyond that, research is seeking for possible additional therapies to increase the effectiveness of TTM.

The sequence of TTM

Induction:
Rapid begin of cooling after ROSC continues to be recommended, however the optimal speed to reach the target temperature remains unclear.

Maintenance:
Effective maintenance of the target temperature without large fluctuations; Shivering must be avoided; A computer-feedback cooling system should be used.

Rewarming:
Slow rewarming using a computer-feedback system.

Normothermia:
Avoid rebound fever after rewarming.