Among adult patients with cardiac arrest, the use of targeted temperature management at 32–34 °C, when compared to normothermia, did not result in improved outcomes in this meta-analysis.

There was no effect of initiating targeted temperature management prior to hospital arrival.

These findings warrant an update of international cardiac arrest guidelines.

The systematic search identified 32 trials.

Risk of bias was assessed as intermediate for most of the outcomes.

For targeted temperature management with a target of 32–34 °C vs. normothermia, 9 trials were identified, with six trials included in meta-analyses.

Targeted temperature management with a target of 32–34 °C did not result in an improvement in survival or favorable neurologic outcome at 90 to 180 days after the cardiac arrest.

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