References

Bernard SA, Smith K, Finn J Induction of therapeutic hypothermia during out-of-hospital cardiac arrest using a rapid infusion of cold saline. Circulation.. 2016; 134:(11)797-805 https://doi.org/10.1161/CIRCULATIONAHA.116.021989

Callahan SJ, Pal K, Jones RM, Davis EM, Kadl A. Temperature control after cardiac arrest. When to start? How long? How cold?. Am J Respirator Crit Care Med.. 2018; 198:(10)1331-1333 https://doi.org/10.1164/rccm.201711-2269RR

Debaty G, Maignan M, Savary D Impact of intra-arrest therapeutic hypothermia in outcomes of prehospital cardiac arrest: a randomized controlled trial. Intens Care Med.. 2014; 40:(12)1832-1842 https://doi.org/10.1007/s00134-014-3519-x

Donnino MW, Andersen LW, Berg KM Temperature Management After Cardiac Arrest. Resuscitation. 2016; 98:97-104 https://doi.org/10.1016/j.resuscitation.2015.09.396

Kim F, Nichol G, Maynard C Effect of prehospital induction of mild hypothermia on survival and neurological status among adults with cardiac arrest. JAMA.. 2014; 311:(1) https://doi.org/10.1001/jama.2013.282173

McDonnell A. Use of targeted temperature management post cardiac arrest. Br J Cardiac Nurs.. 2018; 13:(11)532-538 https://doi.org/10.12968/bjca.2018.13.11.532

Targeted temperature management at 33°C versus 36°C after cardiac arrest [Supplementary Appendix]. 2013. https//www.nejm.org/doi/suppl/10.1056/NEJMoa1310519/suppl_file/nejmoa1310519_appendix.pdf (accessed 25 June 2020)

Nielsen N, Wetterslev J, Cronberg T Targeted temperature management at 33°C versus 36°C after cardiac arrest. New Engl J Med.. 2013; 369:(23)2197-2206 https://doi.org/10.1056/NEJMoa1310519

Nolan J. Advanced life support, 7th edn. London: Resuscitation Council (UK); 2016

Piktel JS, Wilson LD. Targeted temperature management after sudden cardiac arrest: Proarrhythmic or antiarrhythmic?. Probably both. J Crit Care. 2018; 46:149-150 https://doi.org/10.1016/j.jcrc.2018.04.002

Ricketts K, Jones B. Targeted temperature management: beneficial or not?. J Para Pract.. 2020; 12:(6)235-241 https://doi.org/10.12968/jpar.2020.12.6.235

Salcido DD, Sundermann ML, Koller AC, Menegazzi JJ. Incidence and outcomes of rearrest following out-of-hospital cardiac arrest. Resuscitation. 2015; 86:19-24 https://doi.org/10.1016/j.resuscitation.2014.10.011

Scales DC, Cheskes S, Verbeek PR Prehospital cooling to improve successful targeted temperature management after cardiac arrest: A randomized controlled trial. Resuscitation. 2017; 121:187-194 https://doi.org/10.1016/j.resuscitation.2017.10.002

Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. New Engl J Med.. 2002; 346:(8)

Letters

02 July 2020
Opinion
02 July 2020
Volume 12 · Issue 7

Dear Editor,

I was interested to read your published paper on targeted temperature management (TTM) in the latest edition of Journal of Paramedic Practice written by Kelley Ricketts and Bridie Jones. I have a couple of comments that I feel are relevant after recently researching TTM myself.

At best, the efficacy of therapeutic hypothermia remains highly debatable. The HACA (Hypothermia after Cardiac Arrest Study Group, 2002) trial showed clear TTM benefits and changed protocol, then 11 years later, Nielsen et al's (2013) large trial showed no benefit in cooling (both were limited in methodology and prompted questions over generalisability). However, despite the shortcomings of Nielsen et al's trial, its effects were far-reaching, influencing cooling protocols and restricting further trials into TTM (Bernard et al, 2016; McDonnell, 2018). Indeed, the RINSE trial you cited in your paper was an example of a trial being stopped early as hospitals were changing protocol in TTM from 33oC to 36oC based on Nielsen's (2013) findings.

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