Maria Vargas1, Giuseppe Servillo2, Yuda Sutherasan3, Raquel Rodríguez-González4, Iole Brunetti5, Paolo Pelosi6. 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).
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).
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