Targeted Temperature Management
Below is educational information for patients who may need targeted temperature management after a cardiac arrest.
What is Targeted Temperature Management (TTM)?
Targeted Temperature Management (TTM) is a controlled therapy in which the patient’s body temperature is lowered in order to preserve brain function after a cardiac arrest. In most cases, the target temperature is between 32 and 36 degrees Celsius (89.6 to 96.8 degrees Fahrenheit) and this lowered temperature will be maintained for 24 hours. We will then slowly rewarm the patient back to the normal body temperature of 98.6F/37C. The normal body temperature will then be maintained with the cooling therapy device for 72 hours in most cases.
What does this therapy involve?
The patient will be placed on a cooling machine. This can be either a blanket or hydrogel pads. With both devices, water flows in and out, adjusting based on your loved one’s core temperature. The patient will be intubated (have a breathing tube) and may require sedation for this therapy to keep them comfortable.
What are the benefits of this therapy?
Studies show that lowering the core body temperature during the first few hours after a cardiac arrest improves neurological outcomes. Temperature management is believed to decrease swelling and pressure in the brain which can cause further complications after a cardiac arrest. This can also decrease the frequency of seizures. The team of health care providers, including the nurse, intensivist, and neurologist (brain specialist), will work together to make decisions about the patient’s plan of care based on your loved one’s response to therapy.
Care of the patient during TTM
The patient will have a breathing tube and most likely be on other forms of life support. It’s important for the nurse to do mouth care (brush their teeth) and turn them every few hours to protect their skin. Neurological assessments will be completed by nurses and doctors frequently, especially during the rewarming phase of therapy. After target temperature is reached, the patient is maintained at that temperature for 24 hours.
After this, the patient will be “warmed” back to 37 degrees Celsius (98.6F). In most instances, once your loved one has been rewarmed then the sedating medication will be turned down or off for a more in depth neurological assessment.
One of the most frequently asked questions in these situations is, “When will my loved one wake up?” Every case is different, and this can range from a few days, to weeks, to months.
What can I do to help during this time?
As a loved one of the patient, it is important to continue to take care of yourself during this stressful time. Make sure you are getting enough to eat and drink, and getting enough sleep.
The patient is most likely on multiple forms of life support and the room can become crowded. It’s important to try to declutter the environment of your belongings as much as possible in case there is an emergency.
Playing music at a reasonable level (at the discretion of your nurse) may be soothing for the patient and for the loved ones at the bedside.
Please do not hesitate to ask the nurse or doctor any questions you have regarding the therapy. We will always do our best to ensure you are informed and aware of what is taking place.