I'm Anton Hellman.

I'm Justin Morganstern.

And this is the Journal Jam podcast.

EM cases is part of Shremie, the Schwartz-Riseman Emergency Medicine Institute.

That's the nonprofit organization

dedicated to improving EM care through high-quality research and education. If the opinions expressed on this podcast are intended for general information and educational purposes only and should not be used to diagnose treat or prevent any medical condition, nor should they be used as a substitute for medical advice from qualified practicing physician. Unless stated otherwise, the opinions expressed by the hosts or guests are made in their individual capacity, not on behalf of the Institute nor medicine cases.

Therapeutic hypothermia after cardiac arrest is not new.

It was a... expressed by the hosts or guests are made in their individual capacity, not on behalf of the Institute nor medicine cases.

Therapeutic hypothermia after cardiac arrest is not new. It was a thing about 5,000 years ago in Egypt, actually. But fast forward to the 20th century and the first clinical trial of

therapeutic hypothermia after cardiac arrest in 1958 reported an incredible 50% survival. Pretty much the exact same

survival rate that they reported in the recent TTM2 trial. And back in the early 2000s,

therapeutic hypothermia was widespread. As soon as we'd achieved ROSC, we'd go running for the

ice packs and cooled crystalloid and get the ICU on board to set up for that cooling protocol.

It was considered pretty much the standard of care.

We were all convinced that cooling them would not only save their lives, but save their brains so that they could think and talk and walk like they did before the cardiac arrest.

The pathophysiology made sense. The main idea being that cerebral blood flow so that they could think and talk and walk like they did before the cardiac arrest.

The pastoral physiology made sense.

The main idea being that cerebral blood flow and oxygen consumption decreases,

which preserves auto-regulation and saves the brain from ischemic insult and edema.

But as science does with pretty much everything, evidence comes along and changes things.

The famous TTM trial, the original one, was published in 2013.

It was that huge RCT that showed no difference between a target temperature of 33 degrees and 36 degrees.

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