SynthesisFrontiers in public health2026
Comparative efficacy of portable active cooling vs. passive cooling for reducing core temperature in exertional heat stroke: a systematic review and meta-analysis.
Synthesis in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
7 authors.
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Abstract
Background: Exertional heat stroke (EHS) and exercise-induced hyperthermia require rapid reduction of core temperature (Tc). Portable active cooling devices are uesed in field settings where cold-water immersion (the gold standard) is not feasible, but their efficacy compared to passive cooling remains unclear. Objective: This review and analysis compared cooling rates between portable active cooling and passive cooling. Methods: We performed a systematic review and meta-analysis (PRISMA 2020, PROSPERO: CRD420261292698) of randomized and crossover trials. Eligible studies compared portable active cooling (type A: external refrigerant-based cooling systems; type B: wearable pre-cooling systems) with passive cooling in adults with exercise-induced hyperthermia. The primary outcome was mean Tc cooling rate (°C/min), analyzed using a random-effects model. Results: 11 trials ( Conclusions: For field management of exertional heat stroke or severe exercise-induced hyperthermia, portable active cooling systems that use external refrigerant-based cooling (type A) are more effective than passive cooling. Wearable pre-cooling systems (type B) do not demonstrate superior efficacy. Selection of cooling devices should prioritize cooling mechanism over mere portability. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261292698, identifier: CRD420261292698.
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