Vascular pressures and oximetry are optimized through administration of fluids and other support prior to manipulating temperature in a therapeutic hypothermia procedure. Temperature and active hemodynamic management are utilized, through measurement and adjustment of temperature and hemodynamic parameters through the use of an internal cooling device, such as endovascular catheter, and/or an external temperature-altering device, to ensure that temperature management is optimized, and hemodynamics and tissue resuscitation are optimized prior to and during temperature manipulation.