SynthesisCritical care (London, England)2018
The efficacy and safety of pre-hospital cooling after out-of-hospital cardiac arrest: a systematic review and meta-analysis.
Synthesis in Critical care (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 41 citations in OpenAlex.
- Intravascular versus surface cooling for targeted temperature management after out-of-hospital cardiac arrest: an analysis of the TTH48 trial.Critical care (London, England) · 2019Trial
- The Impact of Fluid Resuscitation on Clinical Outcomes According to Transport Time in Out-of-Hospital Cardiac Arrest Patients.Journal of clinical medicine · 2025Article
- Therapeutic Hypothermia Combined with Hydrogen Sulfide Treatment Attenuated Early Blood-Brain Barrier Disruption and Brain Edema Induced by Cardiac Arrest and Resuscitation in Rat Model.Neurochemical research · 2023Article
- Out-of-hospital cardiac arrest complicated by hyperthermia.Resuscitation plus · 2022Article
- Selective Brain Cooling: A New Horizon of Neuroprotection.Frontiers in neurology · 2022Review
- Tele-EMS physicians improve life-threatening conditions during prehospital emergency missions.Scientific reports · 2021Article
- Targeted temperature management and early neuro-prognostication after cardiac arrest.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2021Review
- Photobiomodulation Promotes Hippocampal CA1 NSC Differentiation Toward Neurons and Facilitates Cognitive Function Recovery Involving NLRP3 Inflammasome Mitigation Following Global Cerebral Ischemia.Frontiers in cellular neuroscience · 2021Article
- Emerging Trends and Hot Topics in Cardiopulmonary Resuscitation Research: A Bibliometric Analysis from 2010 to 2019.Medical science monitor : international medical journal of experimental and clinical research · 2020Article
- Fluid Therapy During Cardiopulmonary Resuscitation.Frontiers in veterinary science · 2020Review
- Neurological Prognostication After Cardiac Arrest in the Era of Target Temperature Management.Current neurology and neuroscience reports · 2019Review
- Excluding the Elephant in the Room: Cardiac Arrest.Journal of the American Heart Association · 2019Article
- Airway management in pre-hospital critical care: a review of the evidence for a 'top five' research priority.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Review
- [Expert consensus on neurorestorotherapy for infants/toddlers with brain injury].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2018Article
- Practical considerations for postarrest targeted temperature management.Turkish journal of emergency medicineReview
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMild therapeutic hypothermia (TH), or targeted temperature management, improves survival and neurological outcomes in patients after out-of-hospital cardiac arrest (OHCA). International guidelines strongly support initiating TH for all eligible individuals presenting with OHCA; however, the timing of cooling initiation remains uncertain. This systematic review and meta-analysis was conducted with all available randomised controlled trials (RCTs) included to explore the efficacy and safety of initiating pre-hospital TH in patients with OHCA.
methodsThe MEDLINE and Cochrane databases were searched from inception to October 2017. Inclusion criteria for full-text review included RCTs comparing pre-hospital TH with no pre-hospital TH after cardiac arrest, patients > 14 years of age with documented cardiac arrest from any rhythm, and outcome data that included survival to hospital discharge and temperature at hospital arrival. Results of retrieved studies were compared through meta-analysis using random effects modelling.
resultsA total of 10 trials comprising 4220 patients were included. There were no significant differences between the two arms for the primary outcome of neurological recovery (risk ratio [RR] 1.04, 95% CI 0.93-1.15) or the secondary outcome of survival to hospital discharge (RR 1.01, 95% CI 0.92-1.11). However, there was a significantly lower temperature at hospital arrival in patients receiving pre-hospital TH (mean difference - 0.83, 95% CI - 1.03 to - 0.63). Pre-hospital TH significantly increased the risk of re-arrest (RR 1.19, 95% CI 1.00 to 1.41). No survival differences were observed among subgroups of patients who received intra-arrest TH vs post-arrest TH or who had shockable vs non-shockable rhythms.
conclusionsPre-hospital TH after OHCA effectively decreases body temperature at the time of hospital arrival. However, it does not improve rates of survival with good neurological outcome or overall survival and is associated with increased rates of re-arrest.
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