Editing Cardiac arrest (section)

===Targeted temperature management===
Current international guidelines suggest cooling adults after cardiac arrest using [[targeted temperature management]] (TTM) with the goal of improving neurological outcomes.<ref name="Lindsay-2018">{{cite journal | vauthors = Lindsay PJ, Buell D, Scales DC | title = The efficacy and safety of pre-hospital cooling after out-of-hospital cardiac arrest: a systematic review and meta-analysis | journal = Critical Care | volume = 22 | issue = 1 | pages = 66 | date = March 2018 | pmid = 29534742 | pmc = 5850970 | doi = 10.1186/s13054-018-1984-2 | doi-access = free }}</ref> The process involves cooling for a 24-hour period, with a target temperature of {{convert|32|-|36|C|F|abbr=}}, followed by gradual rewarming over the next 12 to 24 hrs.<ref name="Neumar-2015-3">{{cite journal | vauthors = Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, Brooks SC, de Caen AR, Donnino MW, Ferrer JM, Kleinman ME, Kronick SL, Lavonas EJ, Link MS, Mancini ME, Morrison LJ, O'Connor RE, Samson RA, Schexnayder SM, Singletary EM, Sinz EH, Travers AH, Wyckoff MH, Hazinski MF | display-authors = 6 | title = Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care | journal = Circulation | volume = 132 | issue = 18 Suppl 2 | pages = S315–S367 | date = November 2015 | pmid = 26472989 | doi = 10.1161/cir.0000000000000252 | doi-access = free }}</ref><ref>{{cite book |title=Therapeutic hypothermia after cardiac arrest : clinical application and management |vauthors=Lundbye JB |date=2012 |publisher=Springer |isbn=9781447129509 |location=London |oclc=802346256}}</ref> There are several methods used to lower the body temperature, such as applying ice packs or cold-water circulating pads directly to the body or infusing cold saline.

The effectiveness of TTM after OHCA is an area of ongoing study. Several recent reviews have found that patients treated with TTM have more favorable neurological outcomes.<ref name="Arrich_2023" /><ref name="Schenone-2016" /> However, pre-hospital TTM after OHCA has been shown to increase the risk of adverse outcomes.<ref name="Lindsay-2018" /> The rates of re-arrest may be higher in people who were treated with pre-hospital TTM.<ref name="Lindsay-2018" /> Moreover, TTM may have adverse neurological effects in people who survive post-cardiac arrest''.''<ref>{{cite journal | vauthors = Kalra R, Arora G, Patel N, Doshi R, Berra L, Arora P, Bajaj NS | title = Targeted Temperature Management After Cardiac Arrest: Systematic Review and Meta-analyses | language = en-US | journal = Anesthesia and Analgesia | volume = 126 | issue = 3 | pages = 867–875 | date = March 2018 | pmid = 29239942 | doi = 10.1213/ANE.0000000000002646 | pmc = 5820193 }}</ref> [[Osborn wave|Osborn waves]] on [[ECG]] are frequent during TTM, particularly in patients treated with 33 °C.<ref name="Hadziselimovic_2018">{{cite journal | vauthors = Hadziselimovic E, Thomsen JH, Kjaergaard J, Køber L, Graff C, Pehrson S, Nielsen N, Erlinge D, Frydland M, Wiberg S, Hassager C | display-authors = 6 | title = Osborn waves following out-of-hospital cardiac arrest-Effect of level of temperature management and risk of arrhythmia and death | journal = Resuscitation | volume = 128 | pages = 119–125 | date = July 2018 | pmid = 29723608 | doi = 10.1016/j.resuscitation.2018.04.037 | s2cid = 19236851 | url = https://vbn.aau.dk/da/publications/3ba7eb92-0d81-45fe-8fec-02db97a5f08e }}</ref> [[J wave|Osborn waves]] are not associated with increased risk of ventricular arrhythmia, and may be considered a benign physiological phenomenon, associated with lower mortality in univariable analyses.<ref name="Hadziselimovic_2018" />