title: Effects of in-hospital low targeted temperature after out of hospital cardiac arrest: A systematic review with meta-analysis of randomized clinical trials.
abstract: OBJECTIVE
  We performed this systematic review to evaluate the effectiveness of in-hospital low targeted temperature in adult patients after out of hospital cardiac arrest on survival and neurologic performance.
  
  
  METHODS
  We systematically searched MEDLINE and PUBMED from inception to April 2014.
  
  
  METHODS
  Citations were screened for studies evaluating the effect of in-hospital low targeted temperature in patients following out of hospital cardiac arrest.
  
  
  METHODS
  We analyzed randomized control trials (RCTs) that included adult patients resuscitated from out of hospital cardiac arrest, reporting mortality at hospital discharge and comparing in-hospital low targeted temperature with a control group.
  
  
  RESULTS
  This meta-analysis included 6 RCTs and 1418 adult patients. In-hospital low targeted (low T) temperature was associated to a reduction in mortality at hospital discharge and at 6 months when compared with in-hospital targeted and not targeted temperature while there was no reduction in mortality comparing low and high targeted temperature. In patients with initial ventricular fibrillation/ventricular tachycardia rhythm of out of hospital cardiac arrest, low T was associated with a reduction in short and long-term mortality when compared with no targeted temperature while not when compared to high targeted temperature. Low T was associated with good neurologic performance at hospital discharge compared with in-hospital high or not targeted temperature.
  
  
  CONCLUSIONS
  In-hospital low targeted temperature (<4 °C) improved short and long-term mortality when compared to no targeted temperature. In contrast, low T did not improve outcome compared with a slightly higher targeted temperature (≈ 36 °C).
authors: Department of Neurosciences, Reproductive and Odonthostomatological Sciences, University of Naples "Federico II", Naples, Italy. Electronic address: vargas.maria82@gmail.com.
authors: Maria
authors: M
authors: Vargas
authors: Department of Neurosciences, Reproductive and Odonthostomatological Sciences, University of Naples "Federico II", Naples, Italy.
authors: Giuseppe
authors: G
authors: Servillo
authors: Division of Pulmonary and Critical Care Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors: Yuda
authors: Y
authors: Sutherasan
authors: Research Unit, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain; Critical Patient Translational Research Group, Department of Anesthesiology, Intensive Care and Pain Management, Hospital Clínico Universitario, Instituto de Investigación Sanitaria (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.
authors: Raquel
authors: R
authors: Rodríguez-González
authors: AOU IRCCS San Martino-IST, Genoa, Italy.
authors: Iole
authors: I
authors: Brunetti
authors: Department of Surgical Sciences and Integrated Diagnostics, AOU IRCCS San Martino-IST, University of Genoa, Genoa, Italy.
authors: Paolo
authors: P
authors: Pelosi
mesh_terms: D000328:Adult; D004632:Emergency Medical Services; D006761:Hospitals; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods* / Q000401:mortality; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D010351:Patient Discharge; D015996:Survival Rate
keywords: Cardiac arrest; In hospital; Meta-analysis; Mortality; Neurologic performance; Targeted temperature