• Yibing Zhu, Huibin Huang, Jingzhi Feng, Yu Ren, and Wei Li.
• Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College.
• Medicine (Baltimore). 2020 Aug 28; 99 (35): e21452e21452.

BackgroundThe effectiveness of therapeutic hypothermia (TH) for patients following cardiac arrest with non-shockable rhythm is debated. We plan to conduct a systematic review and meta-analysis with all available randomized controlled trials (RCTs) to explore the efficacy and safety of TH in in this population.MethodsPubMed, EMBASE and Cochrane Library will be searched to identify RCTs published from inception through December 2020 without language restriction. Patients following cardiac arrest due to non-shockable rhythm will be included. The primary outcome is the hospital mortality. The secondary outcome is the favorable neurological outcome. The pooled effects will be analyzed as mean differences using the inverse-variance method for continuous data or as risk ratios using the Mantel-Haenszel method for dichotomous data. Subgroup and sensitivity analyses will be conducted. The Egger's test and/or the funnel plot will be used to test the publication bias. The grades of recommendation assessment, development, and evaluation (GRADE) methodology will be used to assess the quality of evidence. The trial sequential analysis will be used to test whether the meta-analysis is conclusive.ResultsThe RCTs on the effectiveness of TH for patients following cardiac arrest with non-shockable rhythm will be systematically reviewed and advance evidence will be provided.ConclusionAdvanced evidence of TH for cardiac arrest due to non-shockable rhythm will be provided for physicians.Prospero Registration NumberCRD42020161823.

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