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TTM2 Post Cardiac Arrest — FRCA Final MCQ

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HardIntensive Care MedicineTTM2 Post Cardiac ArrestFRCA Final

A patient in ICU is being cooled to 33°C for targeted temperature management after out-of-hospital cardiac arrest (shockable rhythm with ROSC). According to the TTM2 trial (2021), which target temperature has the best evidence?

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Correct answer: E — Active normothermia (≤37.5°C) with aggressive fever prevention

The TTM2 trial (2021) compared hypothermia at 33°C with active normothermia (targeting ≤37.5°C with intervention for fever). There was no difference in mortality or neurological outcome at 6 months. Current Resuscitation Council UK/ERC guidelines (2021/2025) recommend targeted temperature management with active prevention of fever (maintaining ≤37.5°C) for at least 72 hours after ROSC. Active cooling to 33°C is no longer routinely recommended but is not contraindicated.

Reference: Dankiewicz J et al – 2021 – TTM2 trial; Resuscitation Council UK – 2021 – Post-resuscitation care