Acute cardiac care & resuscitation
Effect of cooling methods and target temperature on outcomes in comatose patients resuscitated from cardiac arrest: Systematic review and network meta-analysis of randomized trials
Authors' conclusion
Hypothermia (31..C to 36..C IVC and SC) and active normothermia (Strict-NT and Strict-FP) were associated with better neurological outcomes compared to No-TTM, with IVC having a greater probability of being the better cooling method than SC.
Study context
- Population
- Comatose patients resuscitated from cardiac arrest
- Participants
- 5,218 patients · 15 randomized clinical trials (RCTs)
- Comparison
- Targeted temperature management (TTM) by target temperature and cooling method vs No-TTM
- Outcome
- Neurological recovery
Methodological detailsPUBMED and EMBASE searched until October 8, 2022
- PUBMED and EMBASE searched until October 8, 2022
Pooled result
As reported in the abstract
Neurological outcome
Each group vs No-TTMRelative risk (95% CI)
31..C to 33..C IVC
0.67(0.54–0.83)
31..C to 33..C SC
0.73(0.61–0.87)
34..C to 36..C IVC
0.66(0.51–0.86)
34..C to 36..C SC
0.73(0.59–0.90)
Strict NT or FP
0.75(0.62–0.90)
- 31-33..C intravascular cooling (IVC) highest probability of being best option (ranking P-score)
- 0.836
Further pooled results
| Outcome | IVC | SC |
|---|---|---|
| Cooling method, IVC vs SC (subgroup analysis, ranking P-score)IVC might be a better cooling method than SC | ||
| P-score | 0.960 | 0.670 |
Original publication
Effect of cooling methods and target temperature on outcomes in comatose patients resuscitated from cardiac arrest: Systematic review and network meta-analysis of randomized trials. Am Heart J. Published 11 November 2022. doi:10.
Summarised from the published abstract; every number is checked against it