2019
DOI: 10.1186/s13054-019-2567-6
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Effect of different methods of cooling for targeted temperature management on outcome after cardiac arrest: a systematic review and meta-analysis

Abstract: Background Although targeted temperature management (TTM) is recommended in comatose survivors after cardiac arrest (CA), the optimal method to deliver TTM remains unknown. We performed a meta-analysis to evaluate the effects of different TTM methods on survival and neurological outcome after adult CA. Methods We searched on the MEDLINE/PubMed database until 22 February 2019 for comparative studies that evaluated at least two different TTM methods in CA patients. Data w… Show more

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Cited by 39 publications
(29 citation statements)
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“…Among the various methods that exist to provide TTM, automated devices using a temperature feedback system (TFS) provide a more rapid time to target temperature, less temperature variability, and accurate and slow rewarming compared to external methods, such as ice packs, ice pads, or cold fluids. In a recent systematic review, Calabró et al showed that, although the literature consisted largely of retrospective or prospective studies, the use of core and/or TFS devices was associated with a lower probability of poor neurological outcome when compared to other methods [39]. Although non-automated methods are cheaper and easier to apply, temperature control is poor and their use should be limited to the induction phase in combination with automated devices.…”
Section: Device Selectionmentioning
confidence: 99%
“…Among the various methods that exist to provide TTM, automated devices using a temperature feedback system (TFS) provide a more rapid time to target temperature, less temperature variability, and accurate and slow rewarming compared to external methods, such as ice packs, ice pads, or cold fluids. In a recent systematic review, Calabró et al showed that, although the literature consisted largely of retrospective or prospective studies, the use of core and/or TFS devices was associated with a lower probability of poor neurological outcome when compared to other methods [39]. Although non-automated methods are cheaper and easier to apply, temperature control is poor and their use should be limited to the induction phase in combination with automated devices.…”
Section: Device Selectionmentioning
confidence: 99%
“…Current standards and guidelines for TTM do not recommend a particular method for modifying core temperature, and research comparing different TTM methods is limited [217,218]. One recent retrospective study found endovascular cooling to be more precise than surface cooling, but the neurological outcomes in the two groups were similar [218], while endovascular cooling also requires placing central venous catheters and thus carries its associated risks [94].…”
Section: Targeted Temperature Managementmentioning
confidence: 99%
“…[29] Additional studies in intra-arrest cooling have noted trends toward improvement in cardiac arrest patients with ventricular fibrillation. [30] Currently, both endovascular and surface [31] cooling techniques for TTM in cardiac arrest patients use systemic cooling. Systemic cooling, despite its possible neurologic benefits, has been associated with negative effects including increased pneumonia risk in post-cardiac arrest patients.…”
Section: Therapeutic Hypothermiamentioning
confidence: 99%