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Critical Appraisal of Research

Cardiac arrest is a common health condition that is associated with negative health

impacts including high mortality levels. This is a major concern to the healthcare system as it

poses a major risk to various populations. Neurological injury is also a high risk for patients who

have experienced cardiac arrest. Based on the conducted research, targeted temperature

management (TTM) is one of the most effective approaches that could reduce the risk associated

with neurologic injury among patients with cardiac arrest. Essentially, benefits of TTM have

been clearly outlined by the early studies, a perspective that has been echoed by recent research,

based on the shockable rhythm. Currently, TTM is implemented in various healthcare facilities

through various approaches. The high incidence of out-of-hospital cardiac arrest cases endanger

patients’ lives and the TTM approach is suggested to have a positive impact on the outcomes.

The American Heart Association recommended TTM as a treatment forming part of the

management guidelines involved in post-cardiac arrest. Look et al. (2018) reveal that TTM can

be administered through internal or external cooling, but internal cooling is associated with more

positive outcomes including better survival and temperature control than the external cooling.

Further, the authors explain that internal cooling has a greater capability to achieve rapid cooling

effect and tighter temperature maintenance. Despite internal cooling being the best TTM

approach, it is an invasive approach that increases bleeding and higher risk of infection. These

disadvantages do not make the external better because it might not be invasive but it takes more

time to cool, temperature titration is difficult and increased risk of skin injuries. Fluctuations in

patient temperature are likely to be experienced in the first few hours of implementing the TTM

approach, but these are most likely to wear off after a while. Kalra et al. (2018) also assert that

TTM plays a critical role after cardiac arrest in the post resuscitation care, resulting in positive
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neurologic impacts. Thus, TTM is the best approach after a cardiac arrest, to avert the negative

impacts that could result, affecting the patient’s life.