The effects of hypothermia in thrombosis: a systematic review and meta-analysis

Background: Systemic therapeutic hypothermia is commonly used in patients with craniocerebral injury, cardiopulmonary resuscitation, and high fever, but its effect is still controversial that some reported hypothermia is helpful for thrombosis while someothers thought it had limited effects on thrombosis. In order to explore the effect of intraoperative hypothermia on patients, we analyzed the role of hypothermia in promoting thrombosis, in order to guide the implementation of corresponding countermeasures and timely intervention. Methods: The databases of PubMed, Embase, Cochrane database, and China National Knowledge Infrastructure (CKNI) were used to retrieve relevant studies. The selected literatures were evaluated with Review Manager 5.2. Forest plots, sensitivity analysis, and bias analysis were used to analyze the included studies. Results: A total of 2,053 patients in 8 trials (762 patients were randomly divided into hypothermia group and 1,191 patients in normothermia group) were included in the meta-analysis. High quality randomized evidence suggested that therapeutic hypothermia is associated with thrombosis and high mortality in critically ill patients. Although therapeutic hypothermia may still be beneficial in specific environments, it is best to avoid the routine application of therapeutic hypothermia outside the circumstances specified in the international guidelines (adult cardiac arrest and neonatal hypoxic ischemic encephalopathy). Discussion: This study shows that intraoperative hypothermia is more likely to cause thrombosis, massive hemorrhage, and even death in comparison to routine nursing.T