Keeping Them Cold: Using Data for Target Temperature Management

Inducing hypothermia in patients after cardiac arrest can mitigate reperfusion injuries. But what is the best way to approach this therapy?

In the session “Care of Patients Undergoing Target Temperature Management,” speakers Mary Kay Bader and Teresa Ann Wavra, both with Mission Hospital in Mission Viejo, California, presented clinical data to help nurses determine if the evidence supports their protocols.

“The keys are understanding your patient population and keeping an eye on the research,” Wavra said.
To optimize your unit’s target temperature management (TTM) protocol, it’s important to pay attention to how fast patients can be cooled and how well they can be maintained at that temperature, Wavra said. “Is the machine working harder to keep them cool? That tells you the patient is mounting their hyperthermia response. Do they need fluid? Are they showing signs of infection? Are they seizing? Nurses must be educated on what to look for and what to change. Education is paramount.”

Bader reviewed some of the current controversies about TTM. Data presented shows that inducing hypothermia at 33 degrees C instead of 36 degrees C can be easier to maintain and results in better outcomes.

“The bottom line is you need to collect and analyze data as a CNS,” Wavra says. “The way you change practice is you bring the data to the physician and clinical staff. You must continually educate yourself and your staff so you can say, ‘We need to change our protocol; here’s why.’”

One Response

  1. Linda Mahan says:

    I just experienced my first hypothermia therapy patient. The physician used 33 degree C and there was a decrease in the urine output which a fluid bolts was ordered. I found this article confirmed the assessment the physician and I discussed. Thank you.