UMEM Educational Pearls

Infectious Risks Associated with TTM

  • Targeted temperature management (TTM) is commonly used in the care of patients resuscitated from cardiac arrest.
  • Despite improving neurologic outcomes, TTM can increase the risk of infection, bleeding, coagulopathy, arrhythmias, and electrolyte derangements.
  • Infectious complications of TTM are associated with increases in ICU length of stay, along with increases in the duration of mechanical ventilation.
  • Pneumonia and bacteremia are the two most common infectious complications of TTM, with S.aureus the most common single pathogen isolated in cases of infection.
  • Since TTM may suppress normal signs of infection, it is important to be vigilant for these two infectious complications.
  • At present, evidence does not support prophylactic antibiotics for all patients receiving TTM.

References

Kuchena A, et al. Postcardiac arrest temperature management: infectious risks. Curr Opin Crit Care 2014; 20:507-15.