Critical Care Nursing in Targeted Temperature Management (TTM) After Cardiac Arrest

Abstract

Targeted temperature management (TTM) is a complex and sophisticated intensive-care procedure that is included in the American Heart Association guidelines for treating patients who remain unconscious after resuscitation from cardiac arrest. TTM has been demonstrated to reduce brain injury associated with reperfusion after resuscitation and to improve the neurological prognosis in patients with cardiac arrest. The TTM process may be divided into four phases: induction, maintenance, rewarming, and normothermia. The critical element in TTM is the quick lowering and slow raising of body temperature, which should be fine-tuned to maintain temperature stability and minimize variation. Caregivers should monitor the physiological changes caused by core body temperature change closely and manage possible complications such as shivering, hypo- and hyper-glycemia, electrolyte imbalance, skin injury, arrhythmia, and infection. Based on contemporary evidence and clinical experience, this article provides critical care nurses a summary and key points of each stage of TTM when used to take care of resuscitated patients after cardiac arrest. We hope this work may help improve patient safety and quality of care during the TTM procedure.