Two landmark trials published in 2002 found that targeted temperature management (TTM) after out-of-hospital cardiac arrest improved neurologic outcomes. The larger of the two trials discovered a decrease in mortality. Such treatment benefits are hard to come by in critical care in general, and especially in out-of-hospital cardiac arrest. With the therapeutic overconfidence that characterises our profession, my institution quickly and completely embraced TTM after these trials were published. Remember, this was “back in the day,” when sepsis management included drotrecogin alfa, Cortrosyn stim tests, strict glucose control (90-120 mg/dL), and horrendous over-resuscitation via the early goal-directed therapy paradigm.
