心搏骤停（CA）后脑损伤是患者致死致残的重要病因之一，而脑保护策略是CA后患者治疗的重点和难点。既往研究对低温治疗是否能够改善患者结局仍有争议。但既往研究存在方法学缺陷和选择偏倚，结果无法广泛推广；而进一步的研究表明，中等程度脑损伤患者可能是低温治疗的获益人群，但亟需生物标志物和多模态监测手段等识别工具；摒弃低温治疗可能使发热比例患者增加，从而导致患者病死率和不良神经预后增加。因此，目前趋势倡导个体化策略：根据神经损伤程度、初始心律、生物标志物及脑电图选择目标温度，并强调规范实施。综上，低温治疗获益关键在于精准识别获益人群并优化体温管理质量。

Brain injury after cardiac arrest is one of the leading causes of morbidity and mortality, and effective neuroprotective strategies continue to represent a significant therapeutic challenge. Previous studies evaluating hypothermic targeted temperature management (TTM) have yielded inconsistent results. However, methodological limitations and selection bias in earlier trials may have reduced the generalizability of their findings. More recent evidence suggests that selected patients, particularly those with moderate hypoxic-ischemic brain injury, may derive benefit from hypothermic TTM, highlighting the importance of early identification of appropriate candidates. In addition, abandonment of hypothermic TTM may increase the incidence of post-resuscitation fever, which is associated with higher mortality and worse neurological outcomes. Therefore, individualized temperature management strategies based on patient characteristics and neurological status may be essential for optimizing outcomes after cardiac arrest. Therefore, the current trend advocates for an individualized strategy: selecting the target temperature based on the severity of neurological injury, initial cardiac rhythm, biomarkers, and electroencephalography, while emphasizing standardized implementation. In summary, the key to achieving benefit from hypothermic therapy lies in accurately identifying the beneficiary population and optimizing the quality of temperature management.