Translating Targeted Temperature Management Trials into Postarrest Care

Scientific evidence is often poorly implemented or misinterpreted when it is incorporated into clinical practice.1 Trends in clinical care after publication of the first TTM (Target Temperature Management 33°C versus 36°C after Out-of-Hospital Cardiac Arrest) trial2 are illustrative and alarming. Aiming to build on remarkable improvements in outcomes in patients after cardiac arrest, the TTM trial used standardized surface or intravascular temperature-management protocols to test whether a targeted temperature of 33°C (hypothermia) was superior to a targeted temperature of 36°C (normothermia). It was not; mortality and neurologic outcomes were similar. After publication of the trial results, surveys from multiple countries . . .