#TTMtrial - Twitter Hashtag

over 2 years ago

Learn MD/DNB Emergency Medicine - Neuro medicine - TTM Trial on RAAONLINE App. Download RAAONLINE App: Android: https://t.co/fSlaHVpc0T IOS: https://t.co/oJAMS4dSCa Contact: +91 9994994266 #Emergencymedicine #Neuromedicine #TTMtrial #forensicmedicine #cardiacarrest

0

10

0

46

Tommaso Scquizzato, MD @tscquizzato

over 4 years ago

Why do mRCTs frequently not confirm sRCTs positive findings in critical care? 1️⃣ sRCT (2002): better survival post-CA with hypothermia at 33°C 2️⃣ mRCT #TTMtrial (2013): no difference 33 vs 36°C 3️⃣ mRCT #TTM2 (2021): no difference 33 vs <37.8°C Answer in the thread🧵 #FOAMcc

tscquizzato's tweet photo. Why do mRCTs frequently not confirm sRCTs positive findings in critical care?

1️⃣ sRCT (2002): better survival post-CA with hypothermia at 33°C

2️⃣ mRCT #TTMtrial (2013): no difference 33 vs 36°C

3️⃣ mRCT #TTM2 (2021): no difference 33 vs <37.8°C

Answer in the thread🧵

#FOAMcc https://t.co/lOw8K6xbuU

5

43

21

9

0

Tommaso Scquizzato, MD @tscquizzato

over 5 years ago

5/ Studies with negative findings can have immediate effects on clinical practice. Even if #TTMtrial did not have negative results (similar outcomes between 36°C and 33°C), it seems to have been interpreted negatively. 🔗 https://t.co/ohXKz5GQWG #FOAMcc

tscquizzato's tweet photo. 5/

Studies with negative findings can have immediate effects on clinical practice.

Even if #TTMtrial did not have negative results (similar outcomes between 36°C and 33°C), it seems to have been interpreted negatively.

🔗 https://t.co/ohXKz5GQWG #FOAMcc https://t.co/RhRZAmEjwV

1

3

2

0

Tommaso Scquizzato, MD @tscquizzato

over 5 years ago

4/ The use of guideline-recommended active cooling decreased after publication of the #TTMtrial. The increase in the mean lowest temperature could mean that many Intensivists have adopted 36°C instead of 33°C or abandoned temperature control. #FOAMcc

1

4

1

0

Tommaso Scquizzato, MD @tscquizzato

over 5 years ago

3/ Also data from Australian and New Zealand ICUs showed that post-#TTMtrial: - The average lowest temperature in the first 24h in ICU increased - Higher risk of fever - Higher adjusted mortality 🔗 https://t.co/H8yZqtM6Xl #FOAMcc

tscquizzato's tweet photo. 3/

Also data from Australian and New Zealand ICUs showed that post-#TTMtrial:
- The average lowest temperature in the first 24h in ICU increased
- Higher risk of fever
- Higher adjusted mortality

🔗 https://t.co/H8yZqtM6Xl #FOAMcc https://t.co/bjTCKybC8F

1

5

1

0

Tommaso Scquizzato, MD @tscquizzato

over 5 years ago

2/ Similar findings were observed in the US: - Use of therapeutic hypothermia decreased from 53% in Q4 of 2013 to 46% in Q1 of 2014 after the December 2013 publication of the #TTMtrial - Risk-adjusted patient survival slightly decreased 🔗 https://t.co/NyrJ8Wr5P0 #FOAMcc

tscquizzato's tweet photo. 2/

Similar findings were observed in the US:
- Use of therapeutic hypothermia decreased from 53% in Q4 of 2013 to 46% in Q1 of 2014 after the December 2013 publication of the #TTMtrial
- Risk-adjusted patient survival slightly decreased

🔗 https://t.co/NyrJ8Wr5P0 #FOAMcc https://t.co/Tzfbx36hPW

1

3

1

0

Tommaso Scquizzato, MD @tscquizzato

over 5 years ago

1/ The #TTMtrial compared a target temperature of 33 vs 36°C. After its publication, temperature management after OHCA in UK ICUs changed: - Increased lowest temp and pts with fever (>38°C) in the first 24h - Higher unadjusted in-h mortality 🔗 https://t.co/crIx28GrnM #FOAMcc