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Resuscitation. 2015 Jun;91:8-18. doi: 10.1016/j.resuscitation.2015.02.038. Epub 2015 Mar 20.

Effects of in-hospital low targeted temperature after out of hospital cardiac arrest: A systematic review with meta-analysis of randomized clinical trials.

Author information

1
Department of Neurosciences, Reproductive and Odonthostomatological Sciences, University of Naples "Federico II", Naples, Italy. Electronic address: vargas.maria82@gmail.com.
2
Department of Neurosciences, Reproductive and Odonthostomatological Sciences, University of Naples "Federico II", Naples, Italy.
3
Division of Pulmonary and Critical Care Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
4
Research Unit, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain; Critical Patient Translational Research Group, Department of Anesthesiology, Intensive Care and Pain Management, Hospital Clínico Universitario, Instituto de Investigación Sanitaria (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.
5
AOU IRCCS San Martino-IST, Genoa, Italy.
6
Department of Surgical Sciences and Integrated Diagnostics, AOU IRCCS San Martino-IST, University of Genoa, Genoa, Italy.

Abstract

OBJECTIVE:

We performed this systematic review to evaluate the effectiveness of in-hospital low targeted temperature in adult patients after out of hospital cardiac arrest on survival and neurologic performance.

DATA SOURCE:

We systematically searched MEDLINE and PUBMED from inception to April 2014.

STUDY SELECTION:

Citations were screened for studies evaluating the effect of in-hospital low targeted temperature in patients following out of hospital cardiac arrest.

DATA EXTRACTION:

We analyzed randomized control trials (RCTs) that included adult patients resuscitated from out of hospital cardiac arrest, reporting mortality at hospital discharge and comparing in-hospital low targeted temperature with a control group.

DATA SYNTHESIS:

This meta-analysis included 6 RCTs and 1418 adult patients. In-hospital low targeted (low T) temperature was associated to a reduction in mortality at hospital discharge and at 6 months when compared with in-hospital targeted and not targeted temperature while there was no reduction in mortality comparing low and high targeted temperature. In patients with initial ventricular fibrillation/ventricular tachycardia rhythm of out of hospital cardiac arrest, low T was associated with a reduction in short and long-term mortality when compared with no targeted temperature while not when compared to high targeted temperature. Low T was associated with good neurologic performance at hospital discharge compared with in-hospital high or not targeted temperature.

CONCLUSION:

In-hospital low targeted temperature (<4 °C) improved short and long-term mortality when compared to no targeted temperature. In contrast, low T did not improve outcome compared with a slightly higher targeted temperature (≈ 36 °C).

KEYWORDS:

Cardiac arrest; In hospital; Meta-analysis; Mortality; Neurologic performance; Targeted temperature

[Indexed for MEDLINE]

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