{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:27:35Z","timestamp":1753885655449,"version":"3.37.3"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,7,22]],"date-time":"2023-07-22T00:00:00Z","timestamp":1689984000000},"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":[[2023,8,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Management of sedation and shivering during targeted temperature management (TTM) after cardiac arrest is limited by a dearth of high-quality evidence to guide clinicians. Data from general intensive care unit (ICU) populations can likely be extrapolated to post-cardiac arrest patients, but clinicians should be mindful of key differences that exist between these populations. Most importantly, the goals of sedation after cardiac arrest are distinct from other ICU patients and may also involve suppression of shivering during TTM. Drug metabolism and clearance are altered considerably during TTM when a low goal temperature is used, which can delay accurate neuroprognostication. When neuromuscular blockade is used to prevent shivering, sedation should be deep enough to prevent awareness and providers should be aware that this can mask clinical manifestations of seizures. However, excessively deep or prolonged sedation is associated with complications including delirium, infections, increased duration of ventilatory support, prolonged ICU length of stay, and delays in neuroprognostication. In this manuscript, we review sedation and shivering management best practices in the post-cardiac arrest patient population.<\/jats:p>","DOI":"10.1093\/ehjacc\/zuad087","type":"journal-article","created":{"date-parts":[[2023,7,22]],"date-time":"2023-07-22T01:10:53Z","timestamp":1689988253000},"page":"518-524","source":"Crossref","is-referenced-by-count":4,"title":["Sedation and shivering management after cardiac arrest"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0767-5102","authenticated-orcid":false,"given":"Bram J","family":"Geller","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine and Cardiovascular Critical Care Services, Maine Medical Center , Portland, ME , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina B","family":"Maciel","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery and Neurocritical Care, University of Florida , Gainesville, FL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa L","family":"May","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Maine Medical Center , Portland, ME , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6366-2859","authenticated-orcid":false,"given":"Jacob C","family":"Jentzer","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,7,22]]},"reference":[{"key":"2023082419563156300_zuad087-B1","doi-asserted-by":"crossref","first-page":"e825","DOI":"10.1097\/CCM.0000000000003299","article-title":"Clinical practice guidelines for the prevention and management of pain, agitation\/sedation, delirium, immobility, and sleep disruption in adult patients in the 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