Hypothermie oder Normothermie oder nur Fiebervermeidung? Was ist „State of the Art“ des Temperaturmanagements (TTM, target temperature management) auf der Intensivstation nach Reanimation? Was steht in den Leitlinien? Wie ist die aktuelle Studienlage? Unsere Experten für Intensivmedizin Dr. med. Oliver Hofer (Chefarzt Intensivstation), Dr. med. Matthias Leiter (Oberarzt Intensivstation) und Dr. med. Sven Kürten (Oberarzt Intensivstation) bringen Licht ins Dunkel dieser wichtigen klinischen Fragestellung und geben Euch einen evidenzbasierten Handlungsleitfaden.

Shownotes | Literaturangaben

Gräsner JT, Herlitz J, Tjelmeland IBM et al (2021) European resuscitation council guidelines 2021: epidemiology of cardiac arrest in europe. Resuscitation 161:61–79

Bernard SA, Gray TW, Buist MD, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N EnglJ Med 2002;346:557-563https://www.nejm.org/doi/full/10.1056/NEJMoa003289

The Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002;346:549-556 https://www.nejm.org/doi/full/10.1056/NEJMoa012689

Nielsen N., Wetterslev J., Cronberg T., Erlinge D., Gasche Y., Hassager C., et al. (2013). Targeted temperature management at 33 degrees C versus 36 degrees C after cardiac arrest. N. Engl. J. Med. 369 2197–2206. 10.1177/2048872619870031 - DOI - PubMed https://www.nejm.org/doi/10.1056/NEJMoa1310519?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200www.ncbi.nlm.nih.gov

Salter R, Bailey M, Bellomo R, Eastwood G, Goodwin A, Nielsen N, Pilcher D, Nichol A, Saxena M, Shehabi Y, Young P; Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation (ANZICS-CORE). Changes in Temperature Management of Cardiac Arrest Patients Following Publication of the Target Temperature Management Trial. Crit Care Med. 2018 Nov;46(11):1722-1730. doi: 10.1097/CCM.0000000000003339. PMID: 30063490.

Dankiewicz J, Cronberg T, Lilja G, et al Hypothermia versus normothermia after out-of-hospital cardiac arrest. N Engl J Med 2021;384:2283-2294. https://www.nejm.org/doi/full/10.1056/NEJMoa2100591 

Fischer M, Wnent J, Gräsner JT et al (2021) Öffentlicher Jahresbericht 2020 des Deutschen Reanimationsregisters: Außerklinische Reanimation 2020 www.reanimationsregister.de/berichte 

Lascarrou, J. B., Meziani, F., Le Gouge, A., Boulain, T., Bousser, J., Belliard, G., Asfar, P., Frat, J. P., Dequin, P. F., Gouello, J. P., Delahaye, A., Hssain, A. A., Chakarian, J. C., Pichon, N., Desachy, A., Bellec, F., Thevenin, D., Quenot, J. P., Sirodot, M., Labadie, F., … Clinical Research in Intensive Care and Sepsis (CRICS) Group and HYPERION Study Group (2015). Therapeutic hypothermia after nonshockable cardiac arrest: the HYPERION multicenter, randomized, controlled, assessor-blinded, superiority trial. Scandinavian journal of trauma, resuscitation and emergency medicine, 23, 26. https://doi.org/10.1186/s13049-015-0103-5 

Awad, A., Taccone, F.S., Jonsson, M. et al. Time to intra-arrest therapeutic hypothermia in out-of-hospital cardiac arrest patients and its association with neurologic outcome: a propensity matched sub-analysis of the PRINCESS trial. Intensive Care Med 46, 1361–1370 (2020). https://doi.org/10.1007/s00134-020-06024-3 

Kirkegaard H, Søreide E, de Haas I, et al. Targeted Temperature Management for 48 vs 24 Hours and Neurologic Outcome After Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2017;318(4):341–350. doi:10.1001/jama.2017.8978 

Targeted Temperature Management for 48 vs 24 Hours and Neurologic Outcome After Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial | Emergency Medicine | JAMA | JAMA Network