Research Article
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Year 2025, Issue: 8, 33 - 40, 11.07.2025
https://doi.org/10.26650/CURARE.2025.1634652

Abstract

References

  • 1 Study Group HACA. Mild therapeutic hypothermia to improve the neurological outcome after cardiac arrest. New England Journal of Medicine. 2002;346(8):549-56. google scholar
  • 2 Walker AC, Johnson NJJEMC. Targeted temperature management and postcardiac arrest care. Emergency Medicine Clinics.2019;37(3):381-93. google scholar
  • 3 Rossetti AO, Oddo M, Logroscino G, Kaplan PW. Prediction after cardiac arrest and hypothermia: a prospective study. Annals of neurology. 2010;67(3):301-7. google scholar
  • 4 Sandroni C, D’Arrigo S, Nolan JP. Prediction after cardiac arrest. Critical Care. 2018;22(1):1-9. google scholar
  • 5 Bernard SA, Grey TW, Buist MD, et al. Treatment of comatose survivors of outof-hospital cardiac arrest with induced hypothermia. New England Journal of Medicine. 2002;346(8):557-63. google scholar
  • 6 Polderman KH. İnduced hypothermia and fever control for the prevention and treatment of neurological injuries. Lancet. 2008;371(9628):1955-69. google scholar
  • 7 Seder DB, Jarrah S. Therapeutic hypothermia for cardiac arrest: A practical approach. Current neurology and neuroscience reports. Critical Care Neurology.2008;8(6):508. google scholar
  • 8 Varon J, Acosta P. Therapeutic hypothermia. Chest. 2008;133(5):1267-74. google scholar
  • 9 Leong SHB, Chan E, Ho BCH, et al. Therapeutic temperature management (TTM): post-resuscitation care for adult cardiac arrest, with recommendations from the National TTM Workgroup. Singapore Medical Journal. 2017;58(7):408. google scholar
  • 10 Nolan JP, Sandroni C, Böttiger BW, et al. European resuscitation council and European society of intensive care medicine guidelines 2021: post-resuscitation care. Resuscitation. 2021;161:220-69. google scholar
  • 11 Merchant RM, Topjian AA, Panchal AR, et al. Executive summary: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16):S337-S57. google scholar
  • 12 Berg KM, Cheng A, Panchal AR, et al. Systems of care: 2020 American Heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16):S580-S604. google scholar
  • 13 Soleimanpour H, Rahmani F, Golzari SE, Safari S. Main complications of mildly induced hypothermia after cardiac arrest: a review article. Journal of Cardiovascular and Thoracic Research. 2014;6(1):1-8. google scholar
  • 14 Israelsson J, Lilja G, Bremer A, Stevenson-Âgren J, Ârestedt K. Post cardiac arrest çare and follow-up in Sweden-a national web-survey. BMC Nursing. 2016;15(1):1-8. google scholar
  • 15 Gaieski DF, Band RA, Abella BS, et al. Early goal-directed hemodynamic optimisation combined with therapeutic hypothermia in comatose survivors of out-of-hospital cardiac arrest. Resuscitation. 2009;80:418-24. google scholar
  • 16 Peberdy MA, Callaway CW, Neumar RW, et al. Post-cardiac arrest çare: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122:S768-S86. google scholar
  • 17 Erb JL, Hravnak M, Rittenberg JC. Therapeutic Hypothermia After Cardiac Arrest. American Journal of Nursing. 2012;112(7):38-44. google scholar
  • 18 Roper N. The Roper-Logan-Tierney. Blueprint for use of nursing models: education, research, practice, and administration. NLN Press, New York, Pub no:14-2696, 1996 (14):289. google scholar
  • 19 Holland K, Jenkins J. Applying the Roper-Logan-Tierney Model in Practice-EBook: Elsevier Health Sciences; 2019. google scholar
  • 20 Carpenito LJ. Nursing Diagnoses: Definitions and Classification (Accessed January 2022, at https://dl.uswr.ac.ir/bitstream/Hannan/138720/1/ 9781608311101.pdf. ) google scholar
  • 21 Andersen LW, Holmberg MJ, Berg KM, Donnino MW, Granfeldt A. In-hospital cardiac arrest: a review. Jama. 2019;321(12):1200-10. google scholar
  • 22 Mecklenburg A, Stamm J, Angriman F et al. Impact of therapeutic hypothermia on bleeding events in adult patients treated with extracorporeal life support peri-cardiac arrest. Journal of Critical Care. 2021;62:12-8. google scholar
  • 23 Manzano F, Navarro MJ, Roldân D et al, Pressure ulcer incidence and risk factors in ventilated intensive care patients. Journal Critical Care. 2010;25(3):469-76. google scholar
  • 24 MozaffarianIi D, Benjamin EJ, Go AS, et al, Heart disease and stroke statistics —2015 update: a report from the American Heart Association, Circulation, 2015;131(4):e29-e322, google scholar
  • 25 Virani SS, Alonso A, Benjamin EJ, et al, Heart disease and stroke statistics —2020 update: a report from the American Heart Association, Circulation, 2020;141:e139-e596, google scholar
  • 26 Cha J-J, Wi J, Vitamin D deficiency and neurological outcome after sudden cardiac arrest, Shock, 2019;52(6):146-52, google scholar
  • 27 Wolfrum S, Radke PW, Pischon T, Willich SN, Schunkert H, Kurowski V, Mild therapeutic hypothermia after cardiac arrest—a nationwide survey on the implementation of the ILCOR guidelines in German intensive care units, Resuscitation, 2007;72(2):207-13, google scholar
  • 28 Geurts M, Macleod MR, Kollmar R, Kremer PH, van der Worp HB, Therapeutic hypothermia and the risk of infection: a systematic review and meta-analysis, Critical Care Medicine, 2014;42(2):231-42, google scholar
  • 29 Lantry J, Dezman Z, Hirshon JM, Pathophysiology, management and complications of hypothermia, British Journal of Hospital Medicine, 2012;73(1):31-7, google scholar
  • 30 François B, Cariou A, Clere-Jehl R et al, Prevention of early ventilatorassociated pneumonia after cardiac arrest, New England Journal of Medicine, 2019;381(19):1831-42, google scholar
  • 31 Alderson S, Mckechnie S, Unrecognised, undertreated, pain in ICU—Causes, effects, and how to do better, Open Journal of Nursing,2013;3(1):1-6, google scholar
  • 32 Devlin JW, Skrobik Y, Gelinas C et al. Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Critical Care Medicine. 2018;46(9):e825-e73. google scholar
  • 33 Kizza IB, Muliira JK. Nurses' pain assessment practices with critically ill adult patients. International Nursing Review. 2015;62(4):573-82. google scholar
  • 34 Roberts BW, Kilgannon JH, Hunter BR, et al. Association between early hyperoxia exposure after resuscitation from cardiac arrest and neurological disability: prospective multicenter protocol-directed cohort study. Circulation. 2018;137(20):2114-24. google scholar
  • 35 Chia YW, Edıc SLL, Loh JK, Leong BS-H, Ong MEH. Beyond return of spontaneous circulation: update on post-cardiac arrest management in the intensive care unit. Singapore Medical Journal. 2021;62(8):444-51. google scholar
  • 36 Zeiner A, Sunder-Plassmann G, Sterz F et al. The effect of mild therapeutic hypothermia on renal function after cardiopulmonary resuscitation in men. Resuscitation. 2004;60(3):253-61. google scholar
  • 37 Skrifvars M, Pettila V, Rosenberg P Castren M. A multiple logistic regression analysis of in-hospital factors related to survival at six months in patients resuscitated from out-of-hospital ventricular fibrillation. Resuscitation. 2003;59(3):319-28. google scholar
  • 38 Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48-79. google scholar
  • 40 Casaer MP, Mesotten D, Hermans G et al. Early versus late parenteral nutrition in critically ill adults. New England Journal of Medicine. 2011;365(6):506-17. google scholar
  • 41 Mostafa SM, Bhandari S, Ritchie G, Gratton N, Wenstone R. Constipation and its implications in the critically ill patient. British Journal of Anaesthesia. 2003;91(6):815-9. google scholar
  • 42 Bro-Jeppesen J, Annborn M, Hassager C et al. Hemodynamics and vasopressor support during targeted temperature management at 33 °C versus 36 °C after out-of-hospital cardiac arrest: a post hoc study of the target temperature management trial. Critical Care Medicine. 2015;43(2):318-27. google scholar
  • 43 Lima-Serrano M, Gonzalez-Mendez M, Martın-Castano C, Alonso-Araujo I, Lima-Rodrıguez J. Predictive validity and reliability of the Braden scale for risk assessment of pressure ulcers in an intensive care unit. Medicina Intensiva (English Edition). 2018;42(2):82-91. google scholar
  • 44 Barakat-Johnson M, Barnett C, Wand T, White K. Medical device-related pressure injuries: An exploratory descriptive study in an acute tertiary hospital in Australia. Journal of Tissue Viability. 2017;26(4):246-53. google scholar
  • 45 Varon J, Acosta P, Wintz R, Mendoza N. Unusual side effect from hydrogel pads during therapeutic hypothermia. Resuscitation. 2008;78(3):248-9. google scholar
  • 46 Mahmood MA, Zweifler RM. Progress in shivering control. Journal of the Neurological Sciences. 2007;261(1-2):47-54. google scholar
  • 47 Badjatia N, Kowalski RG, Schmidt JM, et al. Predictors and clinical implications of shivering during therapeutic normothermia. Neurocritical Care. 2007;6(3):186-91. google scholar
  • 48 Needleman I, Hyun-Ryu J, Brealey D et al. The impact of hospitalisation on dental plaque accumulation: an observational study. Journal of Clinical Periodontology. 2012;39(11):1011-6. google scholar

Nursing Diagnoses of Adult Patients Undergoing Therapeutic Hypothermia After Cardiac Arrest

Year 2025, Issue: 8, 33 - 40, 11.07.2025
https://doi.org/10.26650/CURARE.2025.1634652

Abstract

Objectives: This study aimed to identify the nursing diagnoses of adult patients undergoing therapeutic hypothermia (TH) following cardiac arrest.

Methods: A prospective descriptive study design was used. Data were collected from the intensive care units of four hospitals in Istanbul, Türkiye, between July 2020 and December 2021. The study sample consisted of 50 adult patients who returned to spontaneous rhythm after cardiac arrest and subsequently underwent TH. Data were collected using a researcher-developed “Therapeutic Hypothermia Follow-up Form.”

Results: The mean age of the patients was 59.18 ± 15.64 years, and 82% (n=41) were male. The most common causes of cardiac arrest were respiratory arrest (30%; n=15) and myocardial infarction (30%; n=15). The most frequently identified nursing diagnoses included impaired swallowing, hypothermia, impaired verbal communication, ineffective airway clearance, impaired gas exchange, decreased cardiac output, and impaired skin integrity. Notably, pressure injuries were observed in 80% of the patients.

Conclusion: The findings suggest the need for the development of patient follow-up charts and nursing care algorithms specific to TH practices. The use of such tools may enable the early identification and prevention of potential nursing problems in this patient population.

References

  • 1 Study Group HACA. Mild therapeutic hypothermia to improve the neurological outcome after cardiac arrest. New England Journal of Medicine. 2002;346(8):549-56. google scholar
  • 2 Walker AC, Johnson NJJEMC. Targeted temperature management and postcardiac arrest care. Emergency Medicine Clinics.2019;37(3):381-93. google scholar
  • 3 Rossetti AO, Oddo M, Logroscino G, Kaplan PW. Prediction after cardiac arrest and hypothermia: a prospective study. Annals of neurology. 2010;67(3):301-7. google scholar
  • 4 Sandroni C, D’Arrigo S, Nolan JP. Prediction after cardiac arrest. Critical Care. 2018;22(1):1-9. google scholar
  • 5 Bernard SA, Grey TW, Buist MD, et al. Treatment of comatose survivors of outof-hospital cardiac arrest with induced hypothermia. New England Journal of Medicine. 2002;346(8):557-63. google scholar
  • 6 Polderman KH. İnduced hypothermia and fever control for the prevention and treatment of neurological injuries. Lancet. 2008;371(9628):1955-69. google scholar
  • 7 Seder DB, Jarrah S. Therapeutic hypothermia for cardiac arrest: A practical approach. Current neurology and neuroscience reports. Critical Care Neurology.2008;8(6):508. google scholar
  • 8 Varon J, Acosta P. Therapeutic hypothermia. Chest. 2008;133(5):1267-74. google scholar
  • 9 Leong SHB, Chan E, Ho BCH, et al. Therapeutic temperature management (TTM): post-resuscitation care for adult cardiac arrest, with recommendations from the National TTM Workgroup. Singapore Medical Journal. 2017;58(7):408. google scholar
  • 10 Nolan JP, Sandroni C, Böttiger BW, et al. European resuscitation council and European society of intensive care medicine guidelines 2021: post-resuscitation care. Resuscitation. 2021;161:220-69. google scholar
  • 11 Merchant RM, Topjian AA, Panchal AR, et al. Executive summary: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16):S337-S57. google scholar
  • 12 Berg KM, Cheng A, Panchal AR, et al. Systems of care: 2020 American Heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16):S580-S604. google scholar
  • 13 Soleimanpour H, Rahmani F, Golzari SE, Safari S. Main complications of mildly induced hypothermia after cardiac arrest: a review article. Journal of Cardiovascular and Thoracic Research. 2014;6(1):1-8. google scholar
  • 14 Israelsson J, Lilja G, Bremer A, Stevenson-Âgren J, Ârestedt K. Post cardiac arrest çare and follow-up in Sweden-a national web-survey. BMC Nursing. 2016;15(1):1-8. google scholar
  • 15 Gaieski DF, Band RA, Abella BS, et al. Early goal-directed hemodynamic optimisation combined with therapeutic hypothermia in comatose survivors of out-of-hospital cardiac arrest. Resuscitation. 2009;80:418-24. google scholar
  • 16 Peberdy MA, Callaway CW, Neumar RW, et al. Post-cardiac arrest çare: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122:S768-S86. google scholar
  • 17 Erb JL, Hravnak M, Rittenberg JC. Therapeutic Hypothermia After Cardiac Arrest. American Journal of Nursing. 2012;112(7):38-44. google scholar
  • 18 Roper N. The Roper-Logan-Tierney. Blueprint for use of nursing models: education, research, practice, and administration. NLN Press, New York, Pub no:14-2696, 1996 (14):289. google scholar
  • 19 Holland K, Jenkins J. Applying the Roper-Logan-Tierney Model in Practice-EBook: Elsevier Health Sciences; 2019. google scholar
  • 20 Carpenito LJ. Nursing Diagnoses: Definitions and Classification (Accessed January 2022, at https://dl.uswr.ac.ir/bitstream/Hannan/138720/1/ 9781608311101.pdf. ) google scholar
  • 21 Andersen LW, Holmberg MJ, Berg KM, Donnino MW, Granfeldt A. In-hospital cardiac arrest: a review. Jama. 2019;321(12):1200-10. google scholar
  • 22 Mecklenburg A, Stamm J, Angriman F et al. Impact of therapeutic hypothermia on bleeding events in adult patients treated with extracorporeal life support peri-cardiac arrest. Journal of Critical Care. 2021;62:12-8. google scholar
  • 23 Manzano F, Navarro MJ, Roldân D et al, Pressure ulcer incidence and risk factors in ventilated intensive care patients. Journal Critical Care. 2010;25(3):469-76. google scholar
  • 24 MozaffarianIi D, Benjamin EJ, Go AS, et al, Heart disease and stroke statistics —2015 update: a report from the American Heart Association, Circulation, 2015;131(4):e29-e322, google scholar
  • 25 Virani SS, Alonso A, Benjamin EJ, et al, Heart disease and stroke statistics —2020 update: a report from the American Heart Association, Circulation, 2020;141:e139-e596, google scholar
  • 26 Cha J-J, Wi J, Vitamin D deficiency and neurological outcome after sudden cardiac arrest, Shock, 2019;52(6):146-52, google scholar
  • 27 Wolfrum S, Radke PW, Pischon T, Willich SN, Schunkert H, Kurowski V, Mild therapeutic hypothermia after cardiac arrest—a nationwide survey on the implementation of the ILCOR guidelines in German intensive care units, Resuscitation, 2007;72(2):207-13, google scholar
  • 28 Geurts M, Macleod MR, Kollmar R, Kremer PH, van der Worp HB, Therapeutic hypothermia and the risk of infection: a systematic review and meta-analysis, Critical Care Medicine, 2014;42(2):231-42, google scholar
  • 29 Lantry J, Dezman Z, Hirshon JM, Pathophysiology, management and complications of hypothermia, British Journal of Hospital Medicine, 2012;73(1):31-7, google scholar
  • 30 François B, Cariou A, Clere-Jehl R et al, Prevention of early ventilatorassociated pneumonia after cardiac arrest, New England Journal of Medicine, 2019;381(19):1831-42, google scholar
  • 31 Alderson S, Mckechnie S, Unrecognised, undertreated, pain in ICU—Causes, effects, and how to do better, Open Journal of Nursing,2013;3(1):1-6, google scholar
  • 32 Devlin JW, Skrobik Y, Gelinas C et al. Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Critical Care Medicine. 2018;46(9):e825-e73. google scholar
  • 33 Kizza IB, Muliira JK. Nurses' pain assessment practices with critically ill adult patients. International Nursing Review. 2015;62(4):573-82. google scholar
  • 34 Roberts BW, Kilgannon JH, Hunter BR, et al. Association between early hyperoxia exposure after resuscitation from cardiac arrest and neurological disability: prospective multicenter protocol-directed cohort study. Circulation. 2018;137(20):2114-24. google scholar
  • 35 Chia YW, Edıc SLL, Loh JK, Leong BS-H, Ong MEH. Beyond return of spontaneous circulation: update on post-cardiac arrest management in the intensive care unit. Singapore Medical Journal. 2021;62(8):444-51. google scholar
  • 36 Zeiner A, Sunder-Plassmann G, Sterz F et al. The effect of mild therapeutic hypothermia on renal function after cardiopulmonary resuscitation in men. Resuscitation. 2004;60(3):253-61. google scholar
  • 37 Skrifvars M, Pettila V, Rosenberg P Castren M. A multiple logistic regression analysis of in-hospital factors related to survival at six months in patients resuscitated from out-of-hospital ventricular fibrillation. Resuscitation. 2003;59(3):319-28. google scholar
  • 38 Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48-79. google scholar
  • 40 Casaer MP, Mesotten D, Hermans G et al. Early versus late parenteral nutrition in critically ill adults. New England Journal of Medicine. 2011;365(6):506-17. google scholar
  • 41 Mostafa SM, Bhandari S, Ritchie G, Gratton N, Wenstone R. Constipation and its implications in the critically ill patient. British Journal of Anaesthesia. 2003;91(6):815-9. google scholar
  • 42 Bro-Jeppesen J, Annborn M, Hassager C et al. Hemodynamics and vasopressor support during targeted temperature management at 33 °C versus 36 °C after out-of-hospital cardiac arrest: a post hoc study of the target temperature management trial. Critical Care Medicine. 2015;43(2):318-27. google scholar
  • 43 Lima-Serrano M, Gonzalez-Mendez M, Martın-Castano C, Alonso-Araujo I, Lima-Rodrıguez J. Predictive validity and reliability of the Braden scale for risk assessment of pressure ulcers in an intensive care unit. Medicina Intensiva (English Edition). 2018;42(2):82-91. google scholar
  • 44 Barakat-Johnson M, Barnett C, Wand T, White K. Medical device-related pressure injuries: An exploratory descriptive study in an acute tertiary hospital in Australia. Journal of Tissue Viability. 2017;26(4):246-53. google scholar
  • 45 Varon J, Acosta P, Wintz R, Mendoza N. Unusual side effect from hydrogel pads during therapeutic hypothermia. Resuscitation. 2008;78(3):248-9. google scholar
  • 46 Mahmood MA, Zweifler RM. Progress in shivering control. Journal of the Neurological Sciences. 2007;261(1-2):47-54. google scholar
  • 47 Badjatia N, Kowalski RG, Schmidt JM, et al. Predictors and clinical implications of shivering during therapeutic normothermia. Neurocritical Care. 2007;6(3):186-91. google scholar
  • 48 Needleman I, Hyun-Ryu J, Brealey D et al. The impact of hospitalisation on dental plaque accumulation: an observational study. Journal of Clinical Periodontology. 2012;39(11):1011-6. google scholar
There are 47 citations in total.

Details

Primary Language Turkish
Subjects Surgical Diseases Nursing​​
Journal Section Research Articles
Authors

Deniz Özsoy Erat 0000-0002-4725-6893

Yasemin Uslu 0000-0002-6277-3784

Publication Date July 11, 2025
Submission Date February 6, 2025
Acceptance Date May 7, 2025
Published in Issue Year 2025 Issue: 8

Cite

APA Özsoy Erat, D., & Uslu, Y. (2025). Nursing Diagnoses of Adult Patients Undergoing Therapeutic Hypothermia After Cardiac Arrest. CURARE Journal of Nursing(8), 33-40. https://doi.org/10.26650/CURARE.2025.1634652
AMA Özsoy Erat D, Uslu Y. Nursing Diagnoses of Adult Patients Undergoing Therapeutic Hypothermia After Cardiac Arrest. CURARE Journal of Nursing. July 2025;(8):33-40. doi:10.26650/CURARE.2025.1634652
Chicago Özsoy Erat, Deniz, and Yasemin Uslu. “Nursing Diagnoses of Adult Patients Undergoing Therapeutic Hypothermia After Cardiac Arrest”. CURARE Journal of Nursing, no. 8 (July 2025): 33-40. https://doi.org/10.26650/CURARE.2025.1634652.
EndNote Özsoy Erat D, Uslu Y (July 1, 2025) Nursing Diagnoses of Adult Patients Undergoing Therapeutic Hypothermia After Cardiac Arrest. CURARE Journal of Nursing 8 33–40.
IEEE D. Özsoy Erat and Y. Uslu, “Nursing Diagnoses of Adult Patients Undergoing Therapeutic Hypothermia After Cardiac Arrest”, CURARE Journal of Nursing, no. 8, pp. 33–40, July2025, doi: 10.26650/CURARE.2025.1634652.
ISNAD Özsoy Erat, Deniz - Uslu, Yasemin. “Nursing Diagnoses of Adult Patients Undergoing Therapeutic Hypothermia After Cardiac Arrest”. CURARE Journal of Nursing 8 (July2025), 33-40. https://doi.org/10.26650/CURARE.2025.1634652.
JAMA Özsoy Erat D, Uslu Y. Nursing Diagnoses of Adult Patients Undergoing Therapeutic Hypothermia After Cardiac Arrest. CURARE Journal of Nursing. 2025;:33–40.
MLA Özsoy Erat, Deniz and Yasemin Uslu. “Nursing Diagnoses of Adult Patients Undergoing Therapeutic Hypothermia After Cardiac Arrest”. CURARE Journal of Nursing, no. 8, 2025, pp. 33-40, doi:10.26650/CURARE.2025.1634652.
Vancouver Özsoy Erat D, Uslu Y. Nursing Diagnoses of Adult Patients Undergoing Therapeutic Hypothermia After Cardiac Arrest. CURARE Journal of Nursing. 2025(8):33-40.