title: Therapeutic hypothermia initiated in the pre-hospital setting: a meta-analysis.
abstract: After resuscitation of the cardiac arrest patient, reperfusion to the brain begins a cascade of events that may lead to permanent brain damage. Cooling suppresses the inflammatory response related to ischemia and metabolic demand, improving oxygen supply to anoxic areas. Until recently, cooling was only performed in the hospital setting. Recent studies have questioned whether initiating the cooling process immediately after resuscitation is beneficial in the pre-hospital setting. The primary purpose of this study was to examine the feasibility and safety of pre-hospital hypothermia via data extraction from randomized controlled trials and statistical meta-analysis. Studies included in this analysis did show a significant statistical difference with the ability to lower the body temperature when beginning pre-hospital cooling immediately, making it feasible to start therapeutic hypothermia in the pre-hospital setting. Further research is needed to determine neurological and discharge outcomes as the studies were not powered to determine statistical significance.
authors.affiliation: Department of Family Health, Indiana University School of Nursing, Indianapolis, 46202, USA. dcullen@iupui.edu
authors.forename: Deborah
authors.initials: D
authors.lastname: Cullen
authors.forename: Dustin
authors.initials: D
authors.lastname: Augenstine
authors.forename: LesLee
authors.initials: L
authors.lastname: Kaper
authors.forename: Shawn
authors.initials: S
authors.lastname: Tinkham
authors.forename: Dawn
authors.initials: D
authors.lastname: Utz
mesh_terms: D001831:Body Temperature; D004632:Emergency Medical Services; D005240:Feasibility Studies; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic