Table 3.

Themes, and supporting quotes, identified in response to the question “Do you have any concerns with the current level of evidence for TTM post cardiac arrest?”.

TTM	Supporting quotes
Insufficient evidence	“The TTM trial needs to be replicated. There are issues with the time to significantly different temps and also the bias of clinicians observing neurology in patients with hypothermia induced delayed excretion of sedative agents.” “Not much evidence- really just lack of harm”. “Too few studies”.
Design flaws in trials	“Temperature management in ICU is too late.” “All studies have major weakness/design flaws that limit clinical utility.” “Non-inferiority trial would be better with a RCT designed to see if TTM is better than TH management” “Suggests hypothermia useful. Never tested whether avoidance of hyperthermia is as efficacious.” “There is no conclusive evidence about its efficacy.” “The "evidence’ from TTM Nielsen study did not test the upper limit of temperature that can be tolerated without any harm.”.
Applicability to practice	“Still not sure about the ​< ​36. Currently doing an audit to see how much normothermia occurs. When targeted 32–33, no normothermia during cooling phase.” “Seems to change very frequently and is not uniformly applied.”