title: Mild therapeutic hypothermia in patients resuscitated from out-of-hospital cardiac arrest: A meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Guidelines recommend mild therapeutic hypothermia (MTH) for survivors of out-of-hospital cardiac arrest (OHCA). However, there is little literature demonstrating a survival benefit. We performed a meta-analysis of randomized controlled trials (RCTs) assessing the efficacy of MTH in patients successfully resuscitated from OHCA.
  
  
  METHODS
  Electronic databases were searched for RCT involving MTH in survivors of OHCA, and the results were put through a meta-analysis. The primary endpoint was all-cause mortality, and the secondary endpoint was favorable neurological function. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using the Mantel-Haenszel method. A fixed-effect model was used and, if heterogeneity (I2 ) was >40, effects were analyzed using a random model.
  
  
  RESULTS
  Six RCT (n = 1400 patients) were included. Overall survival was 50.7%, and favorable neurological recovery was 45.5%. Pooled data demonstrated no significant all-cause mortality (OR, 0.81; 95% CI 0.55-1.21) or neurological recovery (OR, 0.77; 95% CI 0.47-1.24). No evidence of publication bias was observed.
  
  
  CONCLUSIONS
  This meta-analysis demonstrated that MTH did not confer benefit on overall survival rate and neurological recovery in patients resuscitated from OHCA.
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Villablanca
authors.forename: Mohammed
authors.initials: M
authors.lastname: Makkiya
authors.forename: Evann
authors.initials: E
authors.lastname: Einsenberg
authors.forename: David F
authors.initials: DF
authors.lastname: Briceno
authors.forename: Christia
authors.initials: C
authors.lastname: Panagiota
authors.forename: Mark
authors.initials: M
authors.lastname: Menegus
authors.forename: Mario
authors.initials: M
authors.lastname: Garcia
authors.forename: Daniel
authors.initials: D
authors.lastname: Sims
authors.affiliation: Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic, Arizona, USA.
authors.forename: Harish
authors.initials: H
authors.lastname: Ramakrishna
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D017408:Guidelines as Topic; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic