The Effect of Therapeutic Hypothermia after Cardiac Arrest on the Neurological Outcome and Survival-A Systematic Review of RCTs Published between 2016 and 2020.

Christian Colls Garrido,Blanca Riquelme Gallego,Juan Carlos Sánchez García,María Montiel Troya,Raquel Rodríguez Blanque,Jonathan Cortés Martín

doi:10.3390/ijerph182211817

Abstract

Therapeutic hypothermia is a treatment used for patients who have suffered cardiorespiratory arrest and remain conscious after the recovery of spontaneous circulation. However, its effectiveness is controversial. The objective of this systematic review is to summarize the scientific evidence available about the effect of therapeutic hypothermia on neurological status and survival in this type of patients. Methodology: A primary search in CINAHL, CUIDEN, Pubmed, Web of Science, and Scopus databases was carried out. Randomized clinical trials (RCT) published from 2016 to 2020 were selected. Results: 17 studies were selected for inclusion and most relevant data were extracted. Methodological quality was assessed by the RoB tool. Conclusions: Although therapeutic hypothermia is a safe technique with few adverse and manageable effects, it has not shown to improve survival rate and neurological status of adult nor pediatric patients. It is possible that its positive effect on neuroprotection could be achieved only by preventing hyperthermia although further investigation is needed.

Highlights

The neurological outcome was assessed though the Cerebral Performance Category scale (CPC) in the majority of trials conducted in adult population and though Vineland Adaptive Behavior
Lilja et al compared the effectiveness of therapeutic hypothermia (TH) at 33 ◦ C and 36 ◦ C, concluding that no benefits on neurologic status were found according to the CPC scale [27]
Regarding temperature management (TTM) use in adult population after Cardiorespiratory arrest (CA), no differences were found in comparison with normothermia

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.Licensee MDPI, Basel, Switzerland.Attribution (CC BY) license (https://creativecommons.org/licenses/by/ 4.0/).Cardiorespiratory arrest (CA) is one of the main causes of death in developed and developing countries. CA is defined as the cardiac failure caused by the cessation of mechanic activity, which is confirmed by poor circulation. The cardiopulmonary resuscitation (CPR)

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Conclusion