{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:22:53Z","timestamp":1787678573772,"version":"build-2784847793"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T00:00:00Z","timestamp":1666310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,24]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Targeted temperature management (TTM), including normothermia and therapeutic hypothermia, is used primarily for comatose patients with return of spontaneous circulation after cardiac arrest or following neurological injury. Despite the potential benefits of TTM, risks associated with physiological alterations, including electrolyte shifts, may require intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Summary<\/jats:title><jats:p>This review describes the normal physiological balance of electrolytes and temperature-related alterations as well as the impact of derangements on patient outcomes, providing general recommendations for repletion and monitoring of key electrolytes, including potassium, phosphate, and magnesium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Frequent monitoring and consideration of patient variables such as renal function and other risk factors for adverse effects are important areas of awareness for clinicians caring for patients undergoing TTM.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ajhp\/zxac307","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T20:27:31Z","timestamp":1666384051000},"page":"102-110","source":"Crossref","is-referenced-by-count":4,"title":["Electrolyte considerations in targeted temperature management"],"prefix":"10.1093","volume":"80","author":[{"given":"Brooke","family":"Barlow","sequence":"first","affiliation":[{"name":"Memorial Hermann Woodlands Medical Center , Shenandoah, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin","family":"Landolf","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reid","family":"LaPlante","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Maryland Medical Center , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Cercone","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, St. Clair Health , Pittsburgh, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Yeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Sinai Hospital of Baltimore , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sona","family":"Ghorashi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandria","family":"Howell","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Armahizer","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Maryland Medical Center , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojdeh S","family":"Heavner","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,10,21]]},"reference":[{"issue":"16","key":"2023021504485027200_","first-page":"S366","article-title":"Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care","volume":"142","author":"Panchal","year":"2020","journal-title":"Circulation."},{"key":"2023021504485027200_","article-title":"Targeted hypothermia temperature management","volume-title":"StatPearls [proprietary data]","author":"Omairi"},{"issue":"2","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/00008506-199504000-00021","article-title":"Side effects of mild hypothermia","volume":"7","author":"Schubert","year":"1995","journal-title":"J Neurosurg Anesthesiol."},{"issue":"5","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1111\/j.1471-4159.1988.tb01111.x","article-title":"Effect of ischemia on the in vivo release of striatal dopamine, glutamate, and \u03b3-aminobutyric acid studied by intracerebral microdialysis","volume":"51","author":"Globus","year":"1988","journal-title":"J Neurochem."},{"issue":"7 suppl","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"S186","DOI":"10.1097\/CCM.0b013e3181aa5241","article-title":"Mechanisms of action, physiological effects, and complications of hypothermia","volume":"37","author":"Polderman","year":"2009","journal-title":"Crit Care Med."},{"issue":"5","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"697","DOI":"10.3171\/jns.2001.94.5.0697","article-title":"Hypophosphatemia and hypomagnesemia induced by cooling in patients with severe head injury","volume":"94","author":"Polderman","year":"2001","journal-title":"J Neurosurg."},{"key":"2023021504485027200_","article-title":"Serum potassium","volume-title":"Clinical Methods: The History, Physical, and Laboratory Examinations.","author":"Rastegar","year":"1990","edition":"3rd ed"},{"issue":"6","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.2215\/CJN.08580813","article-title":"Regulation of potassium homeostasis","volume":"10","author":"Palmer","year":"2015","journal-title":"Clin J Am Soc Nephrol."},{"issue":"7","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1016\/j.amjcard.2017.06.051","article-title":"Temporal pattern and prognostic significance of hypokalemia in patients undergoing targeted temperature management following cardiac arrest","volume":"120","author":"Nayeri","year":"2017","journal-title":"Am J Cardiol."},{"key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.resuscitation.2017.07.003","article-title":"The impact of hypothermia on serum potassium concentration: a systematic review","author":"Buse","year":"2017","journal-title":"Resuscitation."},{"issue":"10","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"2228","DOI":"10.1097\/CCM.0000000000001223","article-title":"Pharmacokinetic and other considerations for drug therapy during targeted temperature management","volume":"43","author":"\u0160unji\u0107","year":"2015","journal-title":"Crit Care Med."},{"issue":"4","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1089\/ther.2018.0037","article-title":"Characterization of the effect of prolonged therapeutic hypothermia on serum magnesium and potassium following neurological injury","volume":"9","author":"Beaulieu","year":"2019","journal-title":"Ther Hypothermia Temp Manag."},{"issue":"1","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1592\/phco.28.1.102","article-title":"Practical pharmacologic aspects of therapeutic hypothermia after cardiac arrest","volume":"28","author":"Arpino","year":"2008","journal-title":"Pharmacotherapy."},{"issue":"2","key":"2023021504485027200_","first-page":"192","article-title":"The evaluation and management of accidental hypothermia","volume":"49","author":"Kempainen","year":"2004","journal-title":"Respir Care."},{"issue":"1","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1089\/ther.2018.0044","article-title":"Targeted temperature management: quantifying the extent of serum electrolyte and blood glucose shifts in postcardiac arrest patients","volume":"10","author":"Xie","year":"2020","journal-title":"Ther Hypothermia Temp Manag."},{"issue":"1","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1177\/1060028013511228","article-title":"Assessment of adverse events and predictors of neurological recovery after therapeutic hypothermia","volume":"48","author":"MacLaren","year":"2014","journal-title":"Ann Pharmacother."},{"issue":"5","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"e319","DOI":"10.1016\/j.amjmed.2020.09.054","article-title":"Hypothermia-induced hypokalemia","volume":"134","author":"Yoshida","year":"2021","journal-title":"Am J Med."},{"issue":"11","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1007\/s00467-012-2175-z","article-title":"Phosphate homeostasis and its role in bone health","volume":"27","author":"Penido","year":"2012","journal-title":"Pediatr Nephrol."},{"key":"2023021504485027200_","article-title":"Calcium and phosphate homeostasis","volume-title":"MDText.com","author":"Shaker","year":"2018"},{"issue":"3","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1042\/CS20100377","article-title":"Phosphate toxicity: new insights into an old problem","volume":"120","author":"Razzaque","year":"2011","journal-title":"Clin Sci."},{"key":"2023021504485027200_","article-title":"Chapter 198: serum inorganic phosphorus","volume-title":"Clinical Methods: The History, Physical, and Laboratory Examinations.","author":"Bansal","year":"1990","edition":"3rd ed"},{"issue":"4","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1002\/(SICI)1522-2594(200004)43:4<611::AID-MRM18>3.0.CO;2-I","article-title":"Temperature dependence of human gastrocnemius pH and high-energy phosphate concentration by noninvasive techniques","volume":"43","author":"Binzoni","year":"2000","journal-title":"Magn Reson Med."},{"issue":"1","key":"2023021504485027200_","first-page":"1","article-title":"Main complications of mild induced hypothermia after cardiac arrest: a review article","volume":"6","author":"Soleimanpour","year":"2014","journal-title":"J Cardiovasc Thorac Res."},{"issue":"9","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1097\/00003246-200109000-00012","article-title":"Reversible hypophosphatemia during moderate hypothermia therapy for brain-injured patients","volume":"29","author":"Aibiki","year":"2001","journal-title":"Crit Care Med."},{"issue":"8","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1111\/j.1399-6576.1988.tb02807.x","article-title":"Calcium, magnesium and phosphate during and after hypothermic cardiopulmonary bypass without temperature correction of acid base status","volume":"32","author":"Kancir","year":"1988","journal-title":"Acta Anaesthesiol Scand."},{"issue":"suppl 1","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"P501","DOI":"10.1186\/cc13691","article-title":"Serum phosphate concentration during the rewarming period after deep hypothermic circulatory arrest","volume":"18","author":"Hayami","year":"2014","journal-title":"Crit Care."},{"issue":"11","key":"2023021504485027200_","first-page":"1017","article-title":"Role of adenosine triphosphate (ATP) in trauma-induced and elective hypothermia","volume":"124","author":"Seekamp","year":"1999","journal-title":"Zentralblatt F\u00fcr Chir."},{"issue":"3","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1210\/jc.2011-1319","article-title":"Approach to the hypophosphatemic patient","volume":"97","author":"Imel","year":"2012","journal-title":"J Clin Endocrinol Metab."},{"issue":"1","key":"2023021504485027200_","doi-asserted-by":"crossref","DOI":"10.1186\/s12871-019-0746-2","article-title":"Impact of hypophosphatemia on outcome of patients in intensive care unit: a retrospective cohort study","volume":"19","author":"Wang","year":"2019","journal-title":"BMC Anesthesiol."},{"issue":"1","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18700\/jnc.200001","article-title":"Targeted temperature management for postcardiac arrest syndrome","volume":"13","author":"Kuroda","year":"2020","journal-title":"J Neurocritical Care."},{"issue":"4","key":"2023021504485027200_","first-page":"S194","article-title":"Assessment of magnesium status for diagnosis and therapy","volume":"23","author":"Elin","year":"2010","journal-title":"Magnes Res."},{"issue":"6","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1007\/s00134-002-1281-y","article-title":"Magnesium in critical illness: metabolism, assessment, and treatment","volume":"28","author":"Noronha","year":"2002","journal-title":"Intensive Care Med."},{"issue":"9125","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/S0140-6736(97)10535-9","article-title":"Magnesium and phosphorus","volume":"352","author":"Weisinger","year":"1998","journal-title":"Lancet."},{"issue":"4","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1097\/01.CCM.0000060867.17556.A0","article-title":"Development of ionized hypomagnesemia is associated with higher mortality rates","volume":"31","author":"Soliman","year":"2003","journal-title":"Crit Care Med."},{"issue":"4","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1089\/ther.2014.0012","article-title":"Magnesium depletion in patients treated with therapeutic hypothermia after cardiac arrest","volume":"4","author":"Mazer-Amirshahi","year":"2014","journal-title":"Ther Hypothermia Temp Manag."},{"issue":"1","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1097\/CCM.0b013e3181fa4301","article-title":"Adverse events and their relation to mortality in out-of-hospital cardiac arrest patients treated with therapeutic hypothermia","volume":"39","author":"Nielsen","year":"2011","journal-title":"Crit Care Med."},{"issue":"9087","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1016\/S0140-6736(97)05048-4","article-title":"Randomised trial of magnesium in in-hospital cardiac arrest","volume":"350","author":"Thel","year":"1997","journal-title":"Lancet."},{"issue":"2","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/BF02454195","article-title":"Magnesium deficiency increases circulating levels of inflammatory cytokines and endothelin","volume":"110","author":"Weglicki","year":"1992","journal-title":"Mol Cell Biochem."},{"issue":"6","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1097\/CCM.0b013e31819fffd3","article-title":"Metabolic benefits of surface counter warming during therapeutic temperature modulation","volume":"37","author":"Badjatia","year":"2009","journal-title":"Crit Care Med."},{"issue":"1","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1089\/ther.2017.0016","article-title":"Magnesium levels and neurologic outcomes in patients undergoing therapeutic hypothermia after cardiac arrest","volume":"8","author":"Perucki","year":"2018","journal-title":"Ther Hypothermia Temp Manag."},{"issue":"1","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"86","DOI":"10.11124\/JBISRIR-2016-003236","article-title":"The use of therapeutic magnesium for neuroprotection during global cerebral ischemia associated with cardiac arrest and cardiac surgery in adults: a systematic review","volume":"15","author":"Pearce","year":"2017","journal-title":"JBI Database Syst Rev Implement Rep."},{"issue":"3","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1007\/s12028-010-9474-7","article-title":"Prevention of shivering during therapeutic temperature modulation: the Columbia anti-shivering protocol","volume":"14","author":"Choi","year":"2011","journal-title":"Neurocrit Care."},{"issue":"1 suppl","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"P502","DOI":"10.1186\/cc13692","article-title":"Influence of baseline magnesium concentrations on shivering in therapeutic temperature modulation","volume":"18","author":"Johnson","year":"2014","journal-title":"Crit Care."},{"issue":"2 suppl","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"S119","DOI":"10.1007\/s12028-015-0171-4","article-title":"Emergency neurological life support: resuscitation following cardiac arrest","volume":"23","author":"Rittenberger","year":"2015","journal-title":"Neurocrit Care."},{"issue":"2","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/JNN.0000000000000340","article-title":"Shivering treatments for targeted temperature management: a review","volume":"50","author":"Jain","year":"2018","journal-title":"J Neurosci Nurs."},{"issue":"7","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1681\/ASN.V1071616","article-title":"Hypomagnesemia","volume":"10","author":"Agus","year":"1999","journal-title":"J Am Soc Nephrol."},{"issue":"2","key":"2023021504485027200_","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/EJA.0b013e32834e13a6","article-title":"Intravenous magnesium re-establishes neuromuscular block after spontaneous recovery from an intubating dose of rocuronium: a randomised controlled trial","volume":"29","author":"Hans","year":"2012","journal-title":"Eur J Anaesthesiol."}],"container-title":["American Journal of Health-System Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article-pdf\/doi\/10.1093\/ajhp\/zxac307\/47162632\/zxac307.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/80\/3\/102\/49182580\/zxac307.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/80\/3\/102\/49182580\/zxac307.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T13:58:11Z","timestamp":1678370291000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajhp\/article\/80\/3\/102\/6768157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,21]]},"references-count":47,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,10,21]]},"published-print":{"date-parts":[[2023,1,24]]}},"URL":"https:\/\/doi.org\/10.1093\/ajhp\/zxac307","relation":{},"ISSN":["1079-2082","1535-2900"],"issn-type":[{"value":"1079-2082","type":"print"},{"value":"1535-2900","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,2,1]]},"published":{"date-parts":[[2022,10,21]]}}}