Targeted temperature management for non-shockable cardiac arrests: the debate must go on

Out-of-hospital cardiac arrest (OHCA) is a major public health issue worldwide, with a current increasing incidence of initial non-shockable rhythms that are associated with worse neurological and global outcome as compared with shockable rhythms (1,2). However, last available registries reported improvements in related short and long term survival rates in non-shockable cardiac arrest (CA) patients (3). The benefit of targeted temperature management (TTM) between 32 and 36 ℃ for at least 24 hours on neurological recovery and survival is established in OHCA from initial shockable rhythms (4,5). Based on this available evidence and consensus of expert opinions, international guidelines suggest the use of TTM in post-CA care for comatose CA patients after initial non-shockable rhythm.