What are the exclusion criteria for targeted temperature management (TTM)?

Updated: Jul 26, 2019
  • Author: Alex Koyfman, MD; Chief Editor: Karlheinz Peter, MD, PhD  more...
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Answer

Answer

Exclusion criteria are in part based on theoretical increases in risk. Many studies have reported increased but nonsignificant increases in risk. Patients for whom hypothermia may carry increased risk include those with the following conditions:

  • Recent major surgery within 14 days - Hypothermia may increase the risk of infection and bleeding.

  • Systemic infection/sepsis - Hypothermia may inhibit immune function and is associated with a small increase in risk of infection.

  • Coma from other causes (drug intoxication, preexisting coma prior to arrest)

  • Known bleeding diathesis or with active ongoing bleeding - Hypothermia may impair the clotting system. Check prothrombin time/partial thromboplastin time (PT/PTT), fibrinogen value, and D-dimer value at admission. (Note: Patients may receive chemical thrombolysis, antiplatelet agents, or anticoagulants if deemed necessary in the treatment of the primary cardiac condition.)

In addition, hypothermia is inappropriate for patients with a valid do not resuscitate order (DNR).


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