Therapeutic hypothermia has had a bit of a rollercoaster ride over the last few years. It was all the rage following three small trials, which initially suggested a significant benefit from cooling patients to 33C following out of hospital VF cardiac arrest. It’s worth noting that the evidence for non shockable rhythmns was never that good.

One criticism of the TTM trial is that patients do not achieve the cooling target very quickly. This has led to a number of pre-hospital services continuing with hypothermia strategies despite TTM. To be honest this is fine as TTM showed no real difference and so one could argue that it does not matter if you do or you don't.

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