TY - JOUR
T1 - Mild therapeutic hypothermia in patients resuscitated from out-of-hospital cardiac arrest
T2 - A meta-analysis of randomized controlled trials
AU - Villablanca, Pedro A.
AU - Makkiya, Mohammed
AU - Einsenberg, Evann
AU - Briceno, David F.
AU - Panagiota, Christia
AU - Menegus, Mark
AU - Garcia, Mario
AU - Sims, Daniel
AU - Ramakrishna, Harish
N1 - Publisher Copyright:
© 2016 Annals of Cardiac Anaesthesia.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - 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.
AB - 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.
KW - Cardiac arrest
KW - Meta-analysis
KW - Therapeutic hypothermia
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U2 - 10.4103/0971-9784.173013
DO - 10.4103/0971-9784.173013
M3 - Article
C2 - 26750667
AN - SCOPUS:84954516915
SN - 0971-9784
VL - 19
SP - 4
EP - 14
JO - Annals of cardiac anaesthesia
JF - Annals of cardiac anaesthesia
IS - 1
ER -