skip to main content

Post-arrest Temperature Management Detail — EECC MCQ

Instant feedback + full explanation. One question, done properly.

ModerateGeneral CardiologyPost-arrest Temperature Management DetailEECC

A 55-year-old man with an out-of-hospital cardiac arrest (OOHCA) due to VF is resuscitated. In the ED, his core temperature is 34°C. He is unconscious (GCS 3). How should temperature be managed in the immediate post-resuscitation period?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Active temperature control targeting 32-36°C for at least 24 hours is recommended; actively prevent fever (>37.7°C) for at least 72 hours after ROSC, as fever worsens neurological outcomes — the TTM2 trial showed the key intervention is fever prevention rather than active cooling to a specific low target

The evolution of post-cardiac arrest temperature management: (1) HACA trial (2002) + Bernard study: cooling to 32-34°C improved neurological outcomes → hypothermia became standard; (2) TTM trial (2013): 33°C vs 36°C → no difference → broader temperature range accepted; (3) TTM2 trial (2021): targeted hypothermia (33°C) vs normothermia (≤37.5°C with active fever prevention) → no difference in outcomes. Current ERC 2021 guidelines: (1) target 32-36°C for at least 24 hours (any temperature in this range is acceptable); (2) the CRITICAL intervention is ACTIVE FEVER PREVENTION (>37.7°C) for at least 72 hours — fever post-ROSC is strongly associated with worse neurological outcomes; (3) controlled rewarming (0.25-0.5°C/hour after hypothermia period); (4) neuroprognostication NOT before 72 hours after normothermia.

Reference: ERC (2021): Post-Resuscitation Care; TTM2 Trial