Background: Targeted temperature management (TTM) has been proved to improve the survival and neurological outcome in cardiac arrest survivors and incorporated as part of post-cardiac arrest care as indicated. However, whether the accumulation of TTM experience also benefits patients not receiving TTM has not been investigated yet.
Objectives: To evaluate the influence of TTM experience on survival and neurological outcomes in cardiac arrest survivors not receiving TTM
Methods: Non-traumatic adult (≥ 18 years-old) cardiac arrest victims who survived to intensive care unit admission were retrospectively recruited from a single tertiary medical center during the period from 2006 to 2009, and 2011 to 2017. The TTM accumulated experience was defined as the sum of TTM cases and categorized by year. The association between TTM accumulated experience and outcomes per year in the cardiac arrest survivors were evaluated.
Results: A total of 1247 patients were enrolled in the final analysis and classified into the TTM group (n=325) and non-TTM group (n=922) based on TTM or not during post-arrest period. In the non-TTM group, the rate of survival-to-hospital discharge increased from 25.9% in 2006 to 44.0% in 2017. As to neurological recovery at hospital discharge, the incidence of good neurological function (CPC: 1-2) increased from 10.3% in 2006 to 36.7% in 2017. Multiple logistic regression demonstrated significant association between TTM accumulated experience and neurological outcome in the non-TTM group. 
Conclusions: The accumulation of TTM experience is associated with improved neurological recovery in cardiac arrest survivors not receiving temperature management.

8 - The accumulated experience of targeted temperature management is associated with improved outcomes in cardiac arrest survivors without temperature management