Table 1 Inclusion and exclusion criteria
Inclusion criteria | |
1. Age of at least 18 years | |
2. Out-of-hospital cardiac arrest (OHCA) of presumed cardiac cause | |
3. Sustained return of spontaneous circulation (ROSC), defined as ROSC when chest compressions have not been required for 20 consecutive minutes and signs of circulation persist | |
4. Unconsciousness (Glasgow Coma Scale (GCS) score of less than 8) after sustained ROSC | |
5. Target temperature management (TTM) is indicated. | |
Exclusion criteria | |
1. Conscious patient (GCS score of at least 8) | |
2. Female of child-bearing potential, unless a negative human chorionic gonadotropin (hCG) test can rule out pregnancy within the inclusion window | |
3. In-hospital cardiac arrest (IHCA) | |
4. OHCA of presumed non-cardiac cause, such as after trauma, dissection/rupture of major artery or arrest caused by hypoxia (i.e., drowning, hanging, etc.) | |
5. Known bleeding diathesis (medically induced coagulopathy does not exclude patient) | |
6. Suspected or confirmed acute intracranial bleeding | |
7. Suspected or confirmed acute ischemic stroke | |
8. Unwitnessed asystole | |
9. Known limitations in therapy and do-not-resuscitate order | |
10. Known disease making 180-day survival unlikely | |
11. Known pre-arrest cerebral performance category (CPC) score of 3 or 4 | |
12. More than 4 h (240 min) from ROSC to randomization | |
13. Systolic blood pressure of less than 80 mm Hg in spite of fluid loading/vasopressor and/or inotropic medication and/or mechanical circulatory support* | |
14. Temperature of less than 30 °C on admission | |
15. Uncorrected blood glucose of less than 2.5 mmol/L at admission |