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This research investigates the effects of hypothermia versus normothermia on patients who have undergone extracorporeal cardiopulmonary resuscitation ECPR following out-of-hospital cardiac arrest OHCA. The trial aims to compare mortality risks, neurological outcomes, and adverse events between these two temperature management strategies. The study addresses uncertainties regarding the best temperature control after ECPR, which is a resuscitation method using ECMO to support heart and lung function during cardiac arrest. Participants receive either hypothermia treatment, where their body temperature is cooled to 33-34C using ECMO with a heat exchanger, or normothermia treatment, where the temperature is maintained at 36C. After reaching the target temperature, it is maintained for 24 hours, followed by a 24-hour rewarming period to 36-37.5C, which is then sustained until ECMO ends or for 24 hours post-rewarming. Additional treatments like sedation, muscle relaxants, antipyretics, and circulatory support may be used as needed. During the trial, participants are closely monitored for survival at discharge about 25 days, neurological function using cerebral performance categories, and adverse events during their intensive care stay approximately two weeks. Follow-up assessments occur at 30 days, 90 days, and one year after admission. The study tracks these outcomes to evaluate which temperature management approach might better support recovery after ECPR in OHCA patients.