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Efficacy of the cooling method for targeted temperature management in post-cardiac arrest patients: A systematic review and meta-analysis

Authors
 Jae Guk Kim  ;  Chiwon Ahn  ;  Hyungoo  ;  Shin Wonhee Kim  ;  Tae Ho Lim  ;  Bo-Hyoung Jang  ;  Youngsuk Cho  ;  Kyu-Sun Choi  ;  Juncheol Lee  ;  Min Kyun Na 
Citation
 RESUSCITATION, Vol.148 : 14-24, 2020-03 
Journal Title
RESUSCITATION
ISSN
 0300-9572 
Issue Date
2020-03
MeSH
Cardiopulmonary Resuscitation* ; Cold Temperature ; Humans ; Hypothermia, Induced* ; Out-of-Hospital Cardiac Arrest* / therapy ; Treatment Outcome
Keywords
Hypothermia ; induced ; Heart arrest ; Patient outcome assessment ; Meta-analysis
Abstract
Objective: This review aimed to compare the efficacy of endovascular cooling devices (ECD), such as Thermogard (R), with surface cooling devices (SCD), such as Arctic Sun (R), in reducing mortality and improving neurological status for patients with post-cardiac arrest undergoing targeted temperature management. Data sources: A systematic literature search was conducted using MEDLINE, EMBASE, and the Cochrane Library to identify randomized controlled trials (ACT) and observational studies (OS) comparing mortality and neurological status for patients treated with ECD or SCD. Results: The meta-analysis comprised 4,401 patients from 2 ACT and 7 OS. For mortality, the overall pooled analysis showed no statistically significant difference between ECD and SCD recipients (RR, 0.93; 95% CI 0.86-1.00; I-2 =0%). Further, no statistically significant difference was observed between ACT (RR, 0.80; 95% CI 0.56-1.14; I-2 =0%) and OS (RR, 0.94; 95% CI 0.85-1.04; I-2 =18%) for in-hospital mortality. For good neurological status of survivors after TTM, the overall pooled analysis showed no statistically significant difference between ECD and SCD (RR, 1.08; 95% CI 0.99 1.18;I-2 = 71%). No statistically significant difference was found between ECD and SCD at hospital discharge in RCT (RR, 0.88; 95% CI 0.61-1.28; I-2 =0%) and at 6 months in OS (RR, 1.03; 95% CI 0.99-1.09; I-2 =32%). Conclusions: The study findings could not show that either ECD or SCD was more effective in terms of survival and improved neurological status for post-cardiac arrest patients.
Full Text
https://www.sciencedirect.com/science/article/pii/S0300957220300058
DOI
10.1016/j.resuscitation.2019.12.025
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190176
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