title: The Role of Targeted Temperature Management in Adult Patients Resuscitated from Nonshockable Cardiac Arrests: An Updated Systematic Review and Meta-Analysis.
abstract: Routine targeted temperature management is recommended for comatose adult patients with return of spontaneous circulation after cardiac arrest. However, the role of targeted temperature management in patients resuscitated from nonshockable cardiac arrests remains uncertain. We conducted an updated systematic review and meta-analysis to evaluate the effects of targeted temperature management in this population. Medline, EMBASE, and Cochrane databases were systematically reviewed for studies published between January 2005 and March 2016, in which targeted temperature management was compared with standard care or normothermia for adult patients resuscitated from nonshockable cardiac arrests. A total of 25 trials that included 5715 patients were identified from 10985 relevant papers. Pooled data showed that targeted temperature management not only associated with improved short-term survival (RR = 1.42, 95% CI: 1.28-1.57) and neurological function (RR = 1.63, 95% CI: 1.39-1.91) but also associated with improved long-term survival (RR = 1.64, 95% CI: 1.27-2.12) and neurological recovery (RR = 1.42, 95% CI: 1.07-1.90) in observational cohort studies. However, more frequent infectious complications were reported in hypothermia-treated patients (RR = 1.46, 95% CI: 1.26-1.70) and the quality of the evidence ranged from moderate to very low.
authors.affiliation: School of Biomedical Engineering, Third Military Medical University, Chongqing 400038, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Song
authors.affiliation: School of Biomedical Engineering, Third Military Medical University, Chongqing 400038, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Wei
authors.affiliation: Emergency Department, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Emergency Department, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
authors.forename: Yubao
authors.initials: Y
authors.lastname: Lu
authors.affiliation: School of Biomedical Engineering, Third Military Medical University, Chongqing 400038, China.
authors.forename: Kaifa
authors.identifier: 0000-0002-6787-5018
authors.initials: K
authors.lastname: Wang
authors.affiliation: School of Biomedical Engineering, Third Military Medical University, Chongqing 400038, China.
authors.forename: Yongqin
authors.identifier: 0000-0002-6114-2382
authors.initials: Y
authors.lastname: Li
mesh_terms: D000328:Adult; D001831:Body Temperature; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002986:Clinical Trials as Topic; D006323:Heart Arrest / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D007035:Hypothermia / Q000150:complications; D007036:Hypothermia, Induced / Q000379:methods*; D015203:Reproducibility of Results; D012306:Risk; D016896:Treatment Outcome