TEME Practice Questions - TEME - Título De Especialista Em Medicina De Emergência (ABRAMEDE, Brazil) Exam

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A 49-year-old male achieves Return of Spontaneous Circulation (ROSC) after 18 minutes of CPR for out-of-hospital ventricular fibrillation. In the emergency department, he remains comatose (GCS 3T) with an intact blood pressure of 124/78 mmHg on a low-dose norepinephrine infusion. What are the current international and ABRAMEDE recommendations regarding Targeted Temperature Management (TTM) in comatose post-cardiac arrest adults?

Maintain a constant core body temperature between 32°C and 36°C or strictly prevent fever (maintaining <=37.5°C) for at least 36 to 72 hours. Induce rapid deep hypothermia to 28°C to 30°C for 48 hours using ice-cold saline infusions. Allow permissive hyperthermia up to 39°C to stimulate cerebral immunologic recovery. Maintain core temperature strictly at 30°C for 12 hours followed by rapid rewarming at 2.0°C per hour.

Correct Answer:

Maintain a constant core body temperature between 32°C and 36°C or strictly prevent fever (maintaining <=37.5°C) for at least 36 to 72 hours.

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