title: The role of the induction of mild hypothermia in adult patient outcomes after cardiac arrest: Systematic review and meta-analysis of randomized controlled studies.
abstract: OBJECTIVE
  To determine whether patients with return of spontaneous circulation (ROSC) following cardiac arrest who received mild hypothermia have improved mortality and neurological outcomes compared with those who do not receive mild hypothermia.
  
  
  METHODS
  Online database searches were performed for English-language randomized controlled trials published before March 2014, comparing mild hypothermia (32-34℃) with normothermia or hypothermia other than mild hypothermia after cardiac arrest, in adults with ROSC. Data were independently extracted using a dedicated form. Mortality rates and neurological outcomes were recorded for the overall population and for in-hospital and prehospital mild hypothermia subgroups.
  
  
  RESULTS
  Seven articles were identified for inclusion in the meta-analysis. Mild hypothermia demonstrated no significant beneficial effects in terms of overall mortality or neurological outcomes. In addition, no significant outcome differences were observed between the pre- and in-hospital subgroups.
  
  
  CONCLUSIONS
  On the basis of this limited data set, mild hypothermia does not improve mortality rates or neurological outcomes in patients with ROSC after cardiac arrest, regardless of the timing of the hypothermia. Larger trials need to be carried out to confirm these findings.
authors.affiliation: Department of Anaesthesiology and Intensive Care Unit, Wannan Medical College, Yijishan Hospital, Wuhu, Anhui, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Yu
authors.affiliation: Department of Translational Medicine, Eastern Piedmont University 'A. Avogadro', Novara, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Longhini
authors.affiliation: Department of Anaesthesiology and Intensive Care Unit, Wannan Medical College, Yijishan Hospital, Wuhu, Anhui, China.
authors.forename: Rongrong
authors.initials: R
authors.lastname: Wu
authors.affiliation: Department of Anaesthesiology and Intensive Care Unit, Wannan Medical College, Yijishan Hospital, Wuhu, Anhui, China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Yao
authors.affiliation: Department of Anaesthesiology and Intensive Care Unit, Wannan Medical College, Yijishan Hospital, Wuhu, Anhui, China.
authors.forename: Weihua
authors.initials: W
authors.lastname: Lu
authors.affiliation: Department of Anaesthesiology and Intensive Care Unit, Wannan Medical College, Yijishan Hospital, Wuhu, Anhui, China jinxj@163.com.
authors.forename: Xiaoju
authors.initials: X
authors.lastname: Jin
mesh_terms: D000328:Adult; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: Therapeutic hypothermia; cardiac arrest; mortality; neurological outcome; return of spontaneous circulation