This is an Advisory Statement by the Advanced Life Support Task Force of the International Liaison Committee on Resuscitation and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation
For more than a decade, mild induced hypothermia (32°C–34°C) has been standard of care for patients remaining comatose after resuscitation from out-of-hospital cardiac arrest with an initial shockable rhythm, and this has been extrapolated to survivors of cardiac arrest with initially nonshockable rhythms and to patients with in-hospital cardiac arrest. Two randomized trials published in 2002 reported a survival and neurologic benefit with mild-induced hypothermia. One recent randomized trial reported similar outcomes in patients treated with targeted temperature management at either 33°C or 36°C. In response to these new data, the International Liaison Committee on Resuscitation (ILCOR) Advanced Life Support (ALS) Task Force performed a systematic review to evaluate 3 key questions:
(1) Should mild induced hypothermia (or some form of targeted temperature management) be used in comatose post-cardiac arrest patients?
(2) If used, what is the ideal timing of the intervention?
(3) If used, what is the ideal duration of the intervention?