3. Targeted Temperature Management [ TTM]
• TTM- REFERS TO STRICT TEMPERATURE CONTROL FOLLOWING
CARDIAC ARREST
• ALL COMATOSE ( ie lacking meaningful response to verbal commands)
ADULT PATIENTS WITH ROSC AFTER CARDIAC ARREST SHOULD HAVE
TTM, WITH A TARGET TEMPERATURE BETWEEN 32 AND 36
DEG.CELSIUS SELECTED AND ACHIEVED, THEN MAINTAINED
CONSTANTLY FOR AT LEAST 24 HOURS
4. MECHANISM OF TTM
• AVOIDANCE OF HYPERTHERMIA
• REDUCTION IN METABOLIC DEMAND
• REDUCTION IN ISCHEMIC –PERFUSION INJURY
5. WHO CAN BENEFIT……
INCLUSIONS
• POST CARDIAC ARREST
• ROSC < 30 MINS FROM TEAM
ARRIVAL
• PATIENT IS COMATOSE
• MAP>= 65mmHg
EXCLUSIONS
• ADVANCED DNR DIRECTIVE
• TRAUMATIC ARREST
• ACTIVE BLEEDING ( INCLUDING
INTRACRANIAL)
• PREGNANCY, RECENT MAJOR
SURGERY, SEVERE SEPSIS
6.
7. CASE
• 24 yr old unhelmetted “aboboyaa” rider was involved in a head-on
collision with a pick up. He is rushed to your facility unresponsive.
• What do you do…….
• After your initial management, patient has ROSC, what do you do
next?
