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Table 1 Differences in detailed targeted temperature management protocol between guidelines and randomized controlled trials

From: Targeted temperature management for adult out-of-hospital cardiac arrest: current concepts and clinical applications

Authors (published year) Target temperature Timing of initiation Time to target temperature Cooling techniques Treatment duration Sedatives Neuromuscular blockades Rewarming methods Management after rewarming
HACA Study Group 2002 [3] 32–34 °C After ROSC at hospital Within 4 h after ROSC External cooling device (TheraKool®) (if the goal was not achieved, ice packs were applied 24 h from cooling Midazolam (0.125 mg/kg/h) and fentanyl (0.002 mg/kg/h) for 32 h Pancuronium (0.1 mg/kg) every 2 h for a total of 32 h Passive rewarming (over a period of 8 h) /
Bernard, et al. 2002 [4] 33 °C After ROSC in the ambulance / Ice packs (Coolcare®) 12 h after hospital arrival Midazolam (2–5 mg) for 24 h Vecronium (8–12 mg) for 24 h Beginning at 18 h, actively rewarmed for the next 6 h by external warming with a heated-air blanket Usual intensive care
CoSTR from ILCOR 2010 [1, 2] Guidelines from AHA, ERC 2010 [18, 19] 32–34 °C Minutes to hours after ROSC / No single methods has proved to be optimal 12–24 h / / / Late hyperthermia (after rewarming post-hypothermia) should be identified and treated
Nielsen, et al. 2013 [7] 33 °C After randomization at hospital, after ROSC As rapidly as possible Ice-cold fluids, ice packs, and intravascular or surface temperature-management devices at the discretions of the sites 28 h after randomization Mandated until the end of the intervention period (36 h) / After 28 h, gradual rewarming to 37 °C (0.5 °C/h) For unconscious patients below 37.5 °C until 72 h after cardiac arrest, with the use of fever control measures at the discretion of the sites
  1. / not described