Pyrexia and neurologic outcomes after therapeutic hypothermia for cardiac arrest

Leary, Marion; Grossestreuer, Anne V.; Iannacone, Stephen; González, Mariana; Shofer, Frances S.; Povey, Clare; Wendell, Gary; Archer, Susan E.; Gaieski, David F.; Abella, Benjamin S.

doi:10.1016/j.resuscitation.2012.11.003

Cited by 114 publications

(72 citation statements)

References 24 publications

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“…[221][222][223][224][225] Fever After TTM For the critical outcomes of survival with good neurologic/ functional outcome and/or survival only, we found verylow-quality evidence from 6 observational studies (n=856) (downgraded for risk of bias and indirectness) that fever after TTM is not associated with outcome. [225][226][227][228][229][230] For the same critical outcomes, we also found very-low-quality evidence from 2 observational studies (n=411) (downgraded for risk of bias, inconsistency, and indirectness) that fever after TTM is associated with poor outcome.…”

Section: Consensus On Sciencementioning

confidence: 57%

Part 4: Advanced Life Support

Nolan¹,

Hazinski²,

Aickin³

et al. 2015

Circulation

557

125

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Questions to be addressed (using the PICO [population, intervention, comparator, outcome] format) 3 were prioritized by ALS Task Force members (by voting). Prioritization criteria included awareness of significant new data and new controversies or questions about practice. Questions about topics no longer relevant to contemporary practice or where little new research has occurred were given lower priority. The ALS Task Force prioritized 42 PICO questions for review. With the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evaluation. The reviewers for each question created a reconciled risk of bias assessment for each of the included studies, using state-of-the-art tools: Cochrane for randomized controlled trials (RCTs), 4 Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 for studies of diagnostic accuracy, 5 and GRADE for observational studies that inform both therapy and prognosis questions. 6 GRADE evidence profile tables 7 were then created to facilitate an evaluation of the evidence in support of each of the critical and important outcomes. The quality of the evidence (or confidence in the estimate of the effect) was categorized as high, moderate, low, or very low, 8 based on the study methodologies and the 5 core GRADE domains of risk of bias, inconsistency, indirectness, imprecision, and other considerations (including publication bias). 9 These evidence profile tables were then used to create a written summary of evidence for each outcome (the consensus on science statements). Whenever possible, consensus-based treatment recommendations were then created. These recommendations (designated as strong or weak) were accompanied by an overall assessment of the evidence and a statement from the task force about the values, preferences, and task force insights that underlie the recommendations. Further details of the methodology that underpinned the evidence evaluation process are found in "Part 2: Evidence Evaluation and Management of Conflicts of Interest."The task force preselected and ranked outcome measures that were used as consistently as possible for all PICO questions. Longer-term, patient-centered outcomes were considered more important than process variables and shorter-term outcomes. For most questions, we used the following hierarchy starting with the most important: long-term survival with neurologically favorable survival, long-term survival, short-term survival, and process variable. In general, longterm was defined as from hospital discharge to 180 days or longer, and short-term was defined as shorter than to hospital discharge. For certain questions (eg, related to defibrillation or confirmation of tracheal tube position), process variables such as termination of fibrillation and correct tube placement were important. A few questions (eg, organ donation) required unique outcomes....

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Section: Consensus On Sciencementioning

confidence: 57%

Part 4: Advanced Life Support

Nolan¹,

Hazinski²,

Aickin³

et al. 2015

Circulation

557

125

View full text Add to dashboard Cite

show abstract

“…3 It is therefore unclear whether the reported treatment effect was due to hypothermia or to the prevention of fever, which is associated with a poor outcome. [9][10][11] We conducted a trial to investigate the benefits and harms of two targeted temperature regimens, both intended to prevent fever, in a broader population of patients with cardiac arrest than previously studied.…”

mentioning

confidence: 99%

Targeted Temperature Management at 33°C versus 36°C after Cardiac Arrest

Nielsen

Wetterslev

Cronberg³

et al. 2013

N Engl J Med

2,465

1,864

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“…We used data from the Penn Alliance for Therapeutic Hypothermia (PATH) registry, a multicenter internet-based clinical registry that was developed to collect information for research on TTM treatment for cardiac arrest [12,13] …”

Section: Methodsmentioning

confidence: 99%

Targeted Temperature Management Following Cardiac Arrest: In-Hospital Trends in Utilization

Narsingam¹

2017

Int J Crit Care Emerg Med

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Pyrexia and neurologic outcomes after therapeutic hypothermia for cardiac arrest

Cited by 114 publications

References 24 publications

Part 4: Advanced Life Support

Part 4: Advanced Life Support

Targeted Temperature Management at 33°C versus 36°C after Cardiac Arrest

Targeted Temperature Management Following Cardiac Arrest: In-Hospital Trends in Utilization

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