Holm A, Kirkegaard H, Taccone F, et al. - As improvement in outcomes following in out-of-hospital cardiac arrest seems unattainable with pre-intensive care unit (ICU) induction of targeted temperature management (TTM) with cold intravenous (iv) fluids, researchers investigated whether this may be because of ineffective cooling and side effects. In this post hoc analysis, they examined a sub-group of patients (n = 352) from the TTH48 trial who underwent or did not receive pre-ICU cooling using cold iv fluids. The time to target temperature (TTT, < 34 °C) was the primary endpoint. This analysis included 352 patients, of those, pre-ICU cold fluids were received by 110. No reduction in the TTT was observed in relation to the start of TTM with cold iv fluids prior to ICU arrival. In terms of mortality or the incidence of side effects, there was no significant between-group difference based on the receipt or non-receipt of pre-ICU cold iv fluids.