title: Therapeutic hypothermia (different depths, durations, and rewarming speeds) for acute ischemic stroke: a meta-analysis.
abstract: OBJECTIVE
  Whether therapeutic hypothermia benefits patients with acute ischemic stroke (AIS) remains controversial. The aim of this study was to evaluate the efficacy and safety of the different depths, durations, and rewarming speeds of therapeutic hypothermia for AIS.
  
  
  METHODS
  The MEDLINE (OVID), EMBASE, and Cochrane Central Register of Controlled Trials were systematically searched for randomized controlled trials (RCTs) of therapeutic hypothermia for AIS from the inception of the databases to October 2013. After data extraction and quality assessment, a meta-analysis was performed using RevMan 5.1.
  
  
  RESULTS
  A total of 6 RCTs involving 252 AIS patients were eligible for the meta-analysis. Subanalyses stratified by depth, duration, and rewarming speed of therapeutic hypothermia were also performed. Our results showed that therapeutic hypothermia was associated with an increased risk of pneumonia (risk ratio = 3.30, 95% CI 1.48-7.34; P = .003, P for heterogeneity = .91, I(2) = 0%). No significant difference was observed between the 2 groups in terms of neurologic outcomes, mortality, and other complications including symptomatic or fatal intracranial hemorrhage, deep vein thrombosis, and atrial fibrillation.
  
  
  CONCLUSIONS
  These limited data suggest that therapeutic hypothermia does not significantly improve stroke outcomes and may lead to higher rates of pneumonia. Multicenter RCTs with larger samples are needed to confirm the current findings.
authors.affiliation: Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Yue-Hong
authors.initials: YH
authors.lastname: Wan
authors.affiliation: Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Nie
authors.affiliation: Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Wang
authors.affiliation: Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China. Electronic address: znhuangchaoyun@gmail.com.
authors.forename: Chao-Yun
authors.initials: CY
authors.lastname: Huang
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology; D002545:Brain Ischemia / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects* / Q000379:methods*; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000209:etiology; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology; D017694:Rewarming / Q000379:methods; D012307:Risk Factors; D020521:Stroke / Q000628:therapy*; D013995:Time; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology
keywords: Acute ischemic stroke; meta-analysis; systematic review; therapeutic hypothermia