In this episode of Critical Matters, Dr. Sergio Zanotti interviews Dr. Niklas Nielsen about targeted temperature management (TTM) for comatose patients post-cardiac arrest. They discuss the historical context of therapeutic hypothermia, the TTM1 and TTM2 clinical trials, and the Hyperion trial. Dr. Nielsen explains the design, results, and implications of these trials, emphasizing the importance of large, high-quality studies and standardized neuroprognostication. He also shares how the TTM2 results have impacted practice at his hospital, advocating for a normothermia approach with strict fever management and conservative neurological prognostication. The conversation concludes with a discussion on the next big questions in cardiac arrest care and the need for humility in science.
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