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Critical Care
Published in: Critical Care 2/2012

Open Access 01-04-2012 | Research

Intra-arrest hypothermia during cardiac arrest: a systematic review

Authors: Sabino Scolletta, Fabio Silvio Taccone, Per Nordberg, Katia Donadello, Jean-Louis Vincent, Maaret Castren

Published in: Critical Care | Issue 2/2012

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Abstract

Introduction

Therapeutic hypothermia is largely used to protect the brain following return of spontaneous circulation (ROSC) after cardiac arrest (CA), but it is unclear whether we should start therapeutic hypothermia earlier, that is, before ROSC.

Methods

We performed a systematic search of PubMed, EMBASE, CINAHL, the Cochrane Library and Ovid/Medline databases using "arrest" OR "cardiac arrest" OR "heart arrest" AND "hypothermia" OR "therapeutic hypothermia" OR "cooling" as keywords. Only studies using intra-arrest therapeutic hypothermia (IATH) were selected for this review. Three authors independently assessed the validity of included studies and extracted data regarding characteristics of the studied cohort (animal or human) and the main outcomes related to the use of IATH: Mortality, neurological status and cardiac function (particularly, rate of ROSC).

Results

A total of 23 animal studies (level of evidence (LOE) 5) and five human studies, including one randomized controlled trial (LOE 1), one retrospective and one prospective controlled study (LOE 3), and two prospective studies without a control group (LOE 4), were identified. IATH improved survival and neurological outcomes when compared to normothermia and/or hypothermia after ROSC. IATH was also associated with improved ROSC rates and with improved cardiac function, including better left ventricular function, and reduced myocardial infarct size, when compared to normothermia.

Conclusions

IATH improves survival and neurological outcome when compared to normothermia and/or conventional hypothermia in experimental models of CA. Clinical data on the efficacy of IATH remain limited.
Appendix
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Metadata
Title
Intra-arrest hypothermia during cardiac arrest: a systematic review
Authors
Sabino Scolletta
Fabio Silvio Taccone
Per Nordberg
Katia Donadello
Jean-Louis Vincent
Maaret Castren
Publication date
01-04-2012
Publisher
BioMed Central
Published in
Critical Care / Issue 2/2012
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc11235

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