Targeted Temperature Management in Critical care Neurology


  • Supaporn Konmun Faculty of Medicine, Thammasat University
  • Sornsawan Sriratanaporn Faculty of Medicine, Thammasat University
  • Sorapat Kitti-udom Faculty of Medicine, Thammasat University
  • Sombat Muengtaweepongsa Faculty of Medicine, Thammasat University


Targeted temperature management, Neuroprotective therapy, hypoxic-ischemic cascade, Intracranial pressure, Surface cooling, Endovascular cooling


Two major objectives of targeted temperature management (TTM) in critical care neurology are to provide neuroprotective treatment and to control intracranial pressure (ICP). TTM is the most promising neuroprotective therapy due to its multiple sites of action against hypoxic-ischemic cascade. TTM is useful for ICP reduction. Hypoxic-ischemic brain damage and elevated ICP are common catastrophic conditions in critical care neurology. Two most reliable methods using in clinical practice and clinical trials are invasive endovascular technique and non-invasive surface cooling. Rapid induction, smooth sustainment and gradual rewarming are the important steps to achieve perfect TTM. Shivering is the most important physiologic response found during the process of TTM. Several randomized control trials have indicated that TTM gives favorable outcomes in patients with post-cardiac arrest syndrome (PCAS). Although TTM shows very promising results in pre-clinical studies, its clinical use in patients with ischemic stroke and traumatic brain injury is still controversial. TTM can apply to various clinical conditions associated with hypoxic-ischemic brain injury and elevated ICP in critical care neurology.


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How to Cite

Konmun S, Sriratanaporn S, Kitti-udom S, Muengtaweepongsa S. Targeted Temperature Management in Critical care Neurology. J Thai Stroke Soc [Internet]. 2019 Feb. 13 [cited 2024 Jun. 14];16(3):27-48. Available from:



Original article