POST-CARDIAC ARREST

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

MECHANISM OF TTM
• AVOIDANCE OF HYPERTHERMIA
• REDUCTION IN METABOLIC DEMAND
• REDUCTION IN ISCHEMIC –PERFUSION INJURY

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

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?

•After your initial management, patient
has ROSC, what do you do next?

•You have kept patient on ventilator for
72 hours, what is your step…..