EBQ:TTM Trial - Revision history

T.Boardman: /* Marjor Points */

2019-10-14T18:12:12Z

Marjor Points

← Older revision		Revision as of 18:12, 14 October 2019
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	'''In unconscious survivors of out-of-hospital cardiac arrest of presumed cardiac cause, hypothermia at a targeted temperature of 33°C did not confer a benefit compared with a targeted temperature of 36°C.'''		'''In unconscious survivors of out-of-hospital cardiac arrest of presumed cardiac cause, hypothermia at a targeted temperature of 33°C did not confer a benefit compared with a targeted temperature of 36°C.'''

	==~~Marjor~~ Points==		==Major Points==
	{{Therapeutic hypothermia overview}}		{{Therapeutic hypothermia overview}}



	==Design==		==Design==

2016-03-22T13:58:43Z

← Older revision		Revision as of 13:58, 22 March 2016
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	<references/>		<references/>

	[[Category: Critical Care]] [[Category: ~~Cards~~]][[Category:EBQ]]		[[Category: Critical Care]] [[Category: Cardiology]][[Category:EBQ]]
	[[Category: Featured]]		[[Category: Featured]]

2015-08-06T21:54:15Z

summary

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	==Conclusion==		==Conclusion==
	'''In unconscious survivors of out-of-hospital cardiac arrest of presumed cardiac cause, hypothermia at a targeted temperature of 33°C did not confer a benefit compared with a targeted temperature of 36°C.'''		'''In unconscious survivors of out-of-hospital cardiac arrest of presumed cardiac cause, hypothermia at a targeted temperature of 33°C did not confer a benefit compared with a targeted temperature of 36°C.'''

			==Marjor Points==
			{{Therapeutic hypothermia overview}}



	==Design==		==Design==

2015-08-06T21:52:25Z

Related Publications

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	~~==Related Publications==~~
	*Bernard SA et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002;346:557-63. doi: 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;346:549-56. doi: 10.1056/NEJMoa012689
	*Nielsen N et al. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med Nov 17 2013 doi: 10.1056/NEJMoa1310519
	*Rittenberger JC, Callaway CW. Temperature Management and Modern Post–Cardiac Arrest Care. N Engl J Med Nov 17 2013 doi: 10.1056/NEJMe1312700
	Kim F et al. Effect of Prehospital Induction of Mild Hypothermia on Survival and Neurological Status Among Adults With Cardiac ArrestA Randomized Clinical Trial. JAMA Nov 17 2013 doi:10.1001/jama.2013.282173
	*Granger CB, Becker LB. Randomized Clinical Trial Progress to Inform Care for Out-of-Hospital Cardiac Arrest. JAMA Nov 17 2013 doi:10.1001/jama.2013.282174
	*Granger CB, Becker LB. Randomized Clinical Trial Progress to Inform Care for Out-of-Hospital Cardiac Arrest. JAMA Nov 17 2013 doi:10.1001/jama.2013.282174
	==Sources==		==Sources==
	<references/>		<references/>

2015-08-06T21:38:59Z

2015-08-06T21:36:10Z

Discussion

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	*The study was powered to detect a RRR of 20% or an ARR of ~11%, so the study was not powered to detect a smaller treatment effect		*The study was powered to detect a RRR of 20% or an ARR of ~11%, so the study was not powered to detect a smaller treatment effect
	* TTM differs from the Bernard 2002 and HACA 2002 trials since it was a larger multi center randomized controlled trial with rhythms not limited to VT/VF		* TTM differs from the Bernard 2002 and HACA 2002 trials since it was a larger multi center randomized controlled trial with rhythms not limited to VT/VF
			*Hypothermia, as compared with therapeutic normothermia, did not confer a significant benefit in survival with a good functional outcome at 1 year.<ref>Moler FW. et al. Therapeutic hypothermia after out-of-hospital cardiac arrest in children. N Engl J Med. 2015 May 14;372(20):1898-908</ref>

	===Criticism===		===Criticism===

2015-01-18T23:51:41Z

← Older revision		Revision as of 23:51, 18 January 2015
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	\| journal=The New England Journal of Medicine		\| journal=The New England Journal of Medicine
	\| year=2013		\| year=2013
	\| volume=		\| volume= 369
	\| issue=		\| issue= 23
	\| pages=		\| pages=2197-2206
	\| pmid=		\| pmid= 24237006
	\| fulltexturl=http://www.nejm.org/doi/full/10.1056/NEJMoa1310519		\| fulltexturl=http://www.nejm.org/doi/full/10.1056/NEJMoa1310519
	\| pdfurl=http://www.nejm.org/doi/pdf/10.1056/NEJMoa1310519		\| pdfurl=http://www.nejm.org/doi/pdf/10.1056/NEJMoa1310519

2014-10-01T16:12:22Z

← Older revision		Revision as of 16:12, 1 October 2014
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	[[Category: Critical Care]] [[Category: Cards]][[Category:EBQ]]		[[Category: Critical Care]] [[Category: Cards]][[Category:EBQ]]
			[[Category: Featured]]

2014-10-01T16:10:31Z

← Older revision		Revision as of 16:10, 1 October 2014
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	==Funding==		==Funding==
	Independent research grants from the Swedish Heart–Lung Foundation, Arbetsmarknadens Försäkringsaktie- bolag Insurance Foundation, Swedish Research Council, Re- gion Skåne (Sweden), National Health Service (Sweden), Thel- ma Zoega Foundation, Krapperup Foundation, Thure Carlsson Foundation, Hans-Gabriel and Alice Trolle-Wachtmeister Foundation for Medical Research, Skåne University Hospital, TrygFonden (Denmark), and European Clinical Research In- frastructures Network		Independent research grants from the Swedish Heart–Lung Foundation, Arbetsmarknadens Försäkringsaktie- bolag Insurance Foundation, Swedish Research Council, Re- gion Skåne (Sweden), National Health Service (Sweden), Thel- ma Zoega Foundation, Krapperup Foundation, Thure Carlsson Foundation, Hans-Gabriel and Alice Trolle-Wachtmeister Foundation for Medical Research, Skåne University Hospital, TrygFonden (Denmark), and European Clinical Research In- frastructures Network
			==See Also==
			{{Hypothermia_Cardiac_Arrest_Links}}


	==Related Publications==		==Related Publications==

2014-10-01T16:08:18Z

Outcomes

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	===Primary Outcomes===		===Primary Outcomes===
	*Survival to end of trial (at least 180 days)		*Survival to end of trial (at least 180 days)
			**33°C: 50%
			**36°C 48%
			::95% CI 0.89-1.28; P=0.51

	===Secondary Outcomes===		===Secondary Outcomes===
	*Composite outcomes of all-cause mortality and poor neurological function (Cerebral Performance Category (CPC) 3 and 4 and modified Rankin Scale (mRS) 4 and 5) at 180 days.		*Composite outcomes of all-cause mortality and poor neurological function (Cerebral Performance Category (CPC) 3 and 4 and modified Rankin Scale (mRS) 4 and 5) at 180 days.
	*All – cause mortality and CPC and mRS at 180 – days		*All – cause mortality and CPC and mRS at 180 – days
			*'''Any Adverse Events'''
			**33°C group: 93%
			**36°C group: 90% (p=0.086)

	*Adverse events:		*Adverse events:
	**Bleeding		**Bleeding