• Minerva anestesiologica · Jun 2018

    Meta Analysis

    Effect of therapeutic hypothermia on survival and neurological outcome in adults suffering cardiac arrest: a systematic review and meta-analysis.

    • Sameh M Hakim, Mona A Ammar, and Mohammad S Reyad.
    • Department of Anesthesiology and Intensive Care, Ain Shams University Faculty of Medicine, Cairo, Egypt - drsmiche@hotmail.com.
    • Minerva Anestesiol. 2018 Jun 1; 84 (6): 720-730.

    IntroductionThe aim of this review was to determine current evidence for the effect of therapeutic hypothermia (TH) on survival and neurological outcome in adults suffering cardiac arrest (CA).Evidence AquisitionWe searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE and NLM databases from 2000 to 2017 using the following terms: hypothermia, cooling, therapeutic, cardiac arrest, resuscitation, cardiopulmonary, CPR. Studies were eligible if they compared TH versus normothermic management in adult humans sustaining CA. Randomized controlled trials (RCT), pilot studies and observational trials were included.Evidence SynthesisTen studies involving 3259 patients were included in meta-analysis. Pooling all eligible studies showed a favorable effect for TH on survival and neurological recovery. However, sensitivity analysis for RCTs showed no benefit on either outcome, while observational trials showed benefit for neurological recovery with just marginally significant benefit regarding survival. Studies including patients with shockable rhythms demonstrated benefit for both outcome measures, while those including patients with any rhythms demonstrated benefit for neurological recovery but not for survival. TH did not benefit patients with non-shockable rhythms. Trials using external cooling favored TH regarding survival and neurological outcome but those using systemic cooling with or without external cooling did not show such benefit. When the overall incidence of complications was pooled, there was a statistically significant shift in odds ratio favoring normothermic management over TH.ConclusionsEvidence from RCTs suggests TH does not improve survival or neurological outcome, while observational trials favor TH over normothermia. TH may be attended with higher risk for complications.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…