Cardiac arrest & resuscitation
Intravascular vs. surface cooling in out-of-hospital cardiac arrest patients receiving hypothermia after hospital arrival: a post hoc analysis of the TTM2 trial
Authors' conclusion
Among OHCA patients randomized to hypothermia in the TTM2 study, intravascular cooling, compared with surface cooling, was associated with better cooling performance.
Study context
- Population
- Out-of-hospital cardiac arrest (OHCA) patients randomised to hypothermia in the TTM2 trial and treated with a cooling deviceof 930 randomised to hypothermia
- Participants
- 876 patients
- Comparison
- Intravascular vs surface cooling for targeted temperature management (TTM) at 33 °C
- Primary endpoint
- Cooling performance: proportion reaching target temperature < 33.5 °C within 4 h, time outside temperature ranges during maintenance, rewarming rate and post-TTM fever
Methodological detailspost hoc analysis, Inverse Probability Treatment Weighting (IPTW) (exploratory outcomes)
- Post hoc analysis
- IPTW (exploratory outcomes)
Primary result
As reported in the abstract
Target temperature reached within 4 h · 4 h
P < 0.001
Further findings
| Outcome | IC | SFC | Estimate | |
|---|---|---|---|---|
| 6-month survival (exploratory, IPTW) · exploratory IPTW analysis | 55.2% | 50.2% | OR for survival 1.22 (95% CI 0.89–1.68) | |
| Survival with good functional outcome (mRS 0-3) (exploratory, IPTW) · 6 monthsExploratory IPTW analysis | 51.1% | 44.9% | OR for survival with good functional outcome 1.28 (95% CI 0.93–1.77) | |
| 0.512Ratio (log scale) |
Original publication
Intravascular vs. surface cooling in out-of-hospital cardiac arrest patients receiving hypothermia after hospital arrival: a post hoc analysis of the TTM2 trial. Intensive Care Med. Published 28 April 2025. doi:10.
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