Mild therapeutic hypothermia in patients resuscitated from out‑of‑hospital cardiac arrest: A meta‑analysis of randomized controlled trials.
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Date
2016-01
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Abstract
Aims: Guidelines recommend mild therapeutic hypothermia (MTH) for survivors of out‑of‑hospital
cardiac arrest (OHCA). However, there is little literature demonstrating a survival benefit. We performed a
meta‑analysis of randomized controlled trials (RCTs) assessing the efficacy of MTH in patients successfully
resuscitated from OHCA. Materials and Methods: Electronic databases were searched for RCT involving
MTH in survivors of OHCA, and the results were put through a meta‑analysis. The primary endpoint was
all‑cause mortality, and the secondary endpoint was favorable neurological function. Odds ratios (ORs) and
95% confidence intervals (CIs) were computed using the Mantel–Haenszel method. A fixed‑effect model
was used and, if heterogeneity (I2) was >40, effects were analyzed using a random model. Results: Six
RCT (n = 1400 patients) were included. Overall survival was 50.7%, and favorable neurological recovery
was 45.5%. Pooled data demonstrated no significant all-cause mortality (OR, 0.81; 95% CI 0.55–1.21)
or neurological recovery (OR, 0.77; 95% CI 0.47–1.24). No evidence of publication bias was observed.
Conclusion: This meta‑analysis demonstrated that MTH did not confer benefit on overall survival rate and
neurological recovery in patients resuscitated from OHCA.
Description
Keywords
Cardiac arrest, Meta‑analysis, Therapeutic hypothermia
Citation
Villablanca Pedro A, Makkiya Mohammed, Einsenberg Evann, Briceno David F, Panagiota Christia, Menegus Mark, Garcia Mario, Sims Daniel, Ramakrishna Harish. Mild therapeutic hypothermia in patients resuscitated from out‑of‑hospital cardiac arrest: A meta‑analysis of randomized controlled trials. Annals of Cardiac Anaesthesia. 2016 Jan; 19(1): 4-14.