Meta-Analysis Comparing Hypothermia Versus Normothermia in Patients After a Cardiac Arrest

被引:7
作者
Duhan, Sanchit [1 ]
Keisham, Bijeta [2 ]
Singh, Sahib [1 ]
Rout, Amit [3 ]
机构
[1] Sinai Hosp Baltimore, Dept Internal Med, Baltimore, MD USA
[2] Sinai Hosp Baltimore, Sinai Ctr Thrombosis Res, Baltimore, MD USA
[3] Univ Louisville, Dept Cardiol, Louisville, KY 40292 USA
关键词
TARGETED TEMPERATURE MANAGEMENT; THERAPEUTIC HYPOTHERMIA; SURVIVORS; RESUSCITATION;
D O I
10.1016/j.amjcard.2023.05.058
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The current American Heart Association 2022 guidelines recommend actively preventing fever by targeting a temperature & LE;37.5 & DEG;C for comatose patients after cardiac arrest. Contemporary randomized controlled trials (RCTs) show conflicting results regarding the benefit of targeted hypothermia (TH). We performed this updated meta-analysis of RCTs to evaluate the role of hypothermia in patients after a cardiac arrest. We searched Cochrane, MEDLINE, and EMBASE from inception to December 2022. Trials with patients randomly allocated for targeted temperature monitoring and reported neurologic and mortality outcomes were included. Statistical analysis was performed using Cochrane Review Manager using the random-effects model and calculated the pooled risk ratios of outcomes using the Mantel-Haenszel method. A total of 12 RCTs and 4,262 patients were included in the review. Compared with normothermia, the TH group had significantly improved neurologic outcomes (risk ratio 0.90, 95% confidence interval 0.83 to 0.98). However, no significant difference in mortality was observed (risk ratio 0.97, 95% confidence interval 0.90 to 1.06) between the groups. This meta-analysis supports the role of TH in patients after a cardiac arrest, especially secondary to improvement in neurologic outcomes. & COPY; 2023 Elsevier Inc. All rights reserved. (Am J Cardiol 2023;201:158-165)
引用
收藏
页码:158 / 165
页数:8
相关论文
共 29 条
[1]  
[Anonymous], 2020, Computer program, V1
[2]   Outcomes validity and reliability of the modified Rankin scale: Implications for stroke clinical trials - A literature review and synthesis [J].
Banks, Jamie L. ;
Marotta, Charles A. .
STROKE, 2007, 38 (03) :1091-1096
[3]   Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia [J].
Bernard, SA ;
Gray, TW ;
Buist, MD ;
Jones, BM ;
Silvester, W ;
Gutteridge, G ;
Smith, K .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 346 (08) :557-563
[4]   Temporal Trends in the Use of Therapeutic Hypothermia for Out-of-Hospital Cardiac Arrest [J].
Bradley, Steven M. ;
Liu, Wenhui ;
McNally, Bryan ;
Vellano, Kimberly ;
Henry, Timothy D. ;
Mooney, Michael R. ;
Burke, M. Nicholas ;
Brilakis, Emrnanouil S. ;
Grunwald, Gary K. ;
Adhaduk, Mehul ;
Donnino, Michael ;
Girotra, Saket .
JAMA NETWORK OPEN, 2018, 1 (07)
[5]  
Cardiac Arrest Registry to Enhance Survival, CARES ANN REP
[6]   A Simple Risk Score for Predicting Neurologic Outcome in Out-of-Hospital Cardiac Arrest Patients After Targeted Temperature Management* [J].
Chung-Ting Chen ;
Jin-Wei Lin ;
Cheng-Hsueh Wu ;
Kuo, Raymond Nien-Chen ;
Chia-Hui Shih ;
Hou, Peter Chuanyi ;
Yen, David Hung-Tsang ;
How, Chorng-Kuang .
CRITICAL CARE MEDICINE, 2022, 50 (03) :428-439
[7]   Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest [J].
Dankiewicz, Josef ;
Cronberg, Tobias ;
Lilja, Gisela ;
Jakobsen, Janus C. ;
Levin, Helena ;
Ullen, Susann ;
Rylander, Christian ;
Wise, Matt P. ;
Oddo, Mauro ;
Cariou, Alain ;
Belohlavek, Jan ;
Hovdenes, Jan ;
Saxena, Manoj ;
Kirkegaard, Hans ;
Young, Paul J. ;
Pelosi, Paolo ;
Storm, Christian ;
Taccone, Fabio S. ;
Joannidis, Michael ;
Callaway, Clifton ;
Eastwood, Glenn M. ;
Morgan, Matt P. G. ;
Nordberg, Per ;
Erlinge, David ;
Nichol, Alistair D. ;
Chew, Michelle S. ;
Hollenberg, Jacob ;
Thomas, Matthew ;
Bewley, Jeremy ;
Sweet, Katie ;
Grejs, Anders M. ;
Christensen, Steffen ;
Haenggi, Matthias ;
Levis, Anja ;
Lundin, Andreas ;
During, Joachim ;
Schmidbauer, Simon ;
Keeble, Thomas R. ;
Karamasis, Grigoris V. ;
Schrag, Claudia ;
Faessler, Edith ;
Smid, Ondrej ;
Otahal, Michal ;
Maggiorini, Marco ;
Wendel Garcia, Pedro D. ;
Jaubert, Paul ;
Cole, Jade M. ;
Solar, Miroslav ;
Borgquist, Ola ;
Leithner, Christoph .
NEW ENGLAND JOURNAL OF MEDICINE, 2021, 384 (24) :2283-2294
[8]   Targeted temperature management following out-of-hospital cardiac arrest: a systematic review and network meta-analysis of temperature targets [J].
Fernando, Shannon M. ;
Di Santo, Pietro ;
Sadeghirad, Behnam ;
Lascarrou, Jean-Baptiste ;
Rochwerg, Bram ;
Mathew, Rebecca ;
Sekhon, Mypinder S. ;
Munshi, Laveena ;
Fan, Eddy ;
Brodie, Daniel ;
Rowan, Kathryn M. ;
Hough, Catherine L. ;
McLeod, Shelley L. ;
Vaillancourt, Christian ;
Cheskes, Sheldon ;
Ferguson, Niall D. ;
Scales, Damon C. ;
Sandroni, Claudio ;
Nolan, Jerry P. ;
Hibbert, Benjamin .
INTENSIVE CARE MEDICINE, 2021, 47 (10) :1078-1088
[9]   Prevalence and effect of fever on outcome following resuscitation from cardiac arrest [J].
Gebhardt, Kory ;
Guyette, Francis X. ;
Doshi, Ankur A. ;
Callaway, Clifton W. ;
Rittenberger, Jon C. .
RESUSCITATION, 2013, 84 (08) :1062-1067
[10]   Mild hypothermia induced by a helmet device: a clinical feasibility study [J].
Hachimi-Idrissi, S ;
Corne, L ;
Ebinger, G ;
Michotte, Y ;
Huyghens, L .
RESUSCITATION, 2001, 51 (03) :275-281