Original ArticlesEnergy Expenditure and Shivering Severity During Targeted Temperature Management at 36°C After Cardiac Arrest A Case SeriesCordoza, Makayla PhD, RN, CCRN-K; Chan, Lingtak-Neander PharmD, BCNSP, FCCP; Bridges, Elizabeth PhD, RN, CCNS, FCCM, FAAN; Carlbom, David J. MD; Thompson, Hilaire PhD, RN, ARNP, CNRN, AGACNP-BC, FAANAuthor Information Division of Sleep and Chronobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Dr Cordoza); Department of Pharmacy, School of Pharmacy (Dr Chan), Department of Biobehavioral Nursing and Health Informatics, School of Nursing (Drs Bridges and Thompson), and Division of Pulmonary, Critical Care & Sleep Medicine, School of Medicine (Dr Carlbom), University of Washington, Seattle. Correspondence: Makayla Cordoza, PhD, RN, CCRN-K, Division of Sleep and Chronobiology, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Dr, 1013 Blockley Hall, Philadelphia, PA 19104 (firstname.lastname@example.org) The authors thank Kimberly Kelly and Brennen White for their assistance with this study and to the CVICU nursing staff for their support. This study was supported by the TL1 Translational Research Training Program, Institute of Translational Health Sciences (1TL1TR002318-01), and the Psi at-Large Chapter of Sigma Theta Tau International Honor Society of Nursing. M.C. has received speaking honoraria from Zoll. For the remaining authors, no conflicts of interest were declared. Critical Care Nursing Quarterly: July/September 2020 - Volume 43 - Issue 3 - p 286-293 doi: 10.1097/CNQ.0000000000000313 Buy Metrics Abstract Patients undergoing targeted temperature management (TTM) after cardiac arrest are at risk for shivering, which increases energy expenditure (EE) and may attenuate TTM benefits. This article reports patterns of EE for patients with and without shivering who received TTM at 36°C after cardiac arrest. Based on 96 case assessments, there were 14 occasions when more than one 15-minute interval period was required to appropriately modify the Bedside Shivering Assessment Scale (BSAS) score. Investigators noted that although higher EE was related to higher BSAS scores, there may be opportunities for earlier detection of shivering. © 2020 Wolters Kluwer Health, Inc. All rights reserved.