SynthesisFrontiers in medicine2026
Survival and neurological outcome in patients treated with extracorporeal membrane oxygenation and therapeutic hypothermia: an updated systematic review and meta-analysis.
Synthesis in Frontiers in medicine, 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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5 authors.
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Abstract
Objective: To assess the impact of therapeutic hypothermia on survival, neurological outcome, and complications in adult patients with cardiac arrest undergoing extracorporeal cardiopulmonary resuscitation (ECPR). Methods: A systematic search of PubMed, Embase, Web of Science, the Cochrane Library, and major Chinese databases was conducted from their inception to March 31, 2026. Randomized controlled trials (RCTs) and non-randomized studies of interventions comparing therapeutic hypothermia with normothermia or fever prevention alone in adult patients undergoing ECPR were included. The primary outcomes were survival and favorable neurological outcome. The secondary outcome was the incidence of complications. A random-effects model was used to calculate pooled risk ratios (RRs) and their 95% confidence intervals (CIs), with results stratified by study design. Results: A total of 31 studies involving 6,184 ECPR patients were included, of which only 3 were RCTs. Pooled randomized trials did not demonstrate a significant benefit of therapeutic hypothermia for either survival to hospital discharge (RR = 1.30, 95% CI: 0.70-2.40, Conclusions: Pooled randomized evidence did not demonstrate better survival or more favorable neurological outcomes with therapeutic hypothermia in ECPR patients; more favorable outcomes were confined to crude observational data at high risk of bias. With certainty of evidence rated low to very low, adequately powered randomized trials are needed before firm conclusions can be drawn. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023435353.
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