What are the protocols for rewarming in 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

Remove cooling blankets (and ice if still in use). The goal is to have the patient warm at about 0.3ºC-0.5ºC per hour up to a target of 36°C. One method is to set the water temperature in the cooling device to 35°C and then increase the water temperature by 0.5°C every 1-2 hours until a stable core body temperature of 36°C has been reached for 1 hour.

Maintain the paralytic agent and sedation until the patient’s temperature reaches 36°C. If infusing, discontinue the paralytic agent first. The sedation may be discontinued at the practitioner’s discretion.

Monitor the patient for hypotension secondary to vasodilatation related to rewarming.

Discontinue potassium infusions.

The goal after rewarming is normothermia (ie, avoidance of hyperthermia). [46]


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