@article{8a5ddb22e581476197f70b21174d42f4,
title = "Systematic review and meta-analysis of intravascular temperature management vs. surface cooling in comatose patients resuscitated from cardiac arrest",
abstract = "Objective: To systematically review the effectiveness and safety of intravascular temperature management (IVTM) vs. surface cooling methods (SCM) for induced hypothermia (IH). Methods: Systematic review and meta-analysis. English-language PubMed, Embase and the Cochrane Database of Systematic Reviews were searched on May 27, 2019. The quality of included observational studies was graded using the Newcastle-Ottawa Quality Assessment tool. The quality of included randomized trials was evaluated using the Cochrane Collaboration's risk of bias tool. Random effects modeling was used to calculate risk differences for each outcome. Statistical heterogeneity and publication bias were assessed using standard methods. Eligibility: Observational or randomized studies comparing survival and/or neurologic outcomes in adults aged 18 years or greater resuscitated from out-of-hospital cardiac arrest receiving IH via IVTM vs. SCM were eligible for inclusion. Results: In total, 12 studies met inclusion criteria. These enrolled 1573 patients who received IVTM; and 4008 who received SCM. Survival was 55.0% in the IVTM group and 51.2% in the SCM group [pooled risk difference 2% (95% CI −1%, 5%)]. Good neurological outcome was achieved in 40.9% in the IVTM and 29.5% in the surface group [pooled risk difference 5% (95% CI 2%, 8%)]. There was a 6% (95% CI 11%, 2%) lower risk of arrhythmia with use of IVTM and 15% (95% CI 22%, 7%) decreased risk of overcooling with use of IVTM vs. SCM. There was no significant difference in other evaluated adverse events between groups. Conclusions: IVTM was associated with improved neurological outcomes vs. SCM among survivors resuscitated following cardiac arrest. These results may have implications for care of patients in the emergency department and intensive care settings after resuscitation from cardiac arrest.",
keywords = "Cardiac arrest, Induced hypothermia, Intravascular temperature management, Surface cooling methods, Targeted temperature management",
author = "Bartlett, {Emily S.} and Terence Valenzuela and Ahamed Idris and Nicolas Deye and Guy Glover and Gillies, {Michael A.} and Taccone, {Fabio S.} and Kjetil Sunde and Flint, {Alexander C.} and Holger Thiele and Jasmin Arrich and Claude Hemphill and Michael Holzer and Skrifvars, {Markus B.} and Undine Pittl and Polderman, {Kees H.} and Ong, {Marcus E.H.} and Kim, {Ki Hong} and Oh, {Sang Hoon} and {Do Shin}, Sang and Hans Kirkegaard and Graham Nichol",
note = "Funding Information: Bartlett — Principal investigator (PI) of a feasibility trial of remote ischemic conditioning funded by ZOLL Foundation, Chelmsford, MA. Deye — Travel reimbursement and speakers fees, Bard Medical Inc., Covington, GA and ZOLL Circulation, San Jose, CA. Flint — Patents in United States and elsewhere on technology for automated shivering detection and treatment. Gillies — Chief Scientist{\textquoteright}s Office (Scotland) NHS Research Scheme Clinician. Glover — Consultant and travel reimbursement, Bard Medical Inc., Covington, GA. Hemphill — Member of Data Safety Monitoring Board, INTREPID trial of fever prevention using Arctic Sun surface method in patients with strokes, funded by BARD Medical Inc. Holzer — PI, Cool AMI EU Pivotal trial of intravascular cooling in patients with STEMI, funded by ZOLL Circulation Inc. PI, trial of cooling with CaerVest device in patients resuscitated from cardiac arrest, funded by Bodychilz Inc., Gatwick, Sussex, United Kingdom; Received speaker fees and travel reimbursement from Bard Medical Inc. and ZOLL Circulation Inc. Idris — Member of the HeartSine (Stryker Belfast) Clinical Advisory Board Nichol — Funding from the Medic One Foundation via an endowed chair at the University of Washington. The foundation promotes improvement in pre-hospital emergency care. His institution received funding from Zoll Medical Corp. and Zoll Circulation Inc. He is the principal investigator (PI) for a national industry-sponsored trial of targeted temperature management (TTM) in patients with STEMI; he disclosed off-label product use of TTM/Induced Hypothermia Devices for use in patients resuscitated from cardiac arrest. He is a consultant to GE Healthcare Inc., Chicago, IL; Kestra Medical Technologies, Kirkland, WA; QOOL Therapeutics, Menlo Park, CA; and ZOLL Circulation Inc, San Jose, CA. Ong — Scientific Advisor to Global Healthcare SG, Singapore. Polderman — Travel reimbursement and speakers fees from Bard Medical Inc., Stryker Inc., ZOLL Medical Inc. Skrifvars: Research funding from GE, Lecture fees from COVIDIEN, MEDTRONIC and BARD. Sunde — Travel reimbursement and speakers fees from Bard Medical Inc., Stryker Inc. Taccone — Lecture fees from BARD and ZOLL All other authors report no disclosures. This review was not funded or sponsored. Appendix A Publisher Copyright: {\textcopyright} 2019 Elsevier B.V.",
year = "2020",
month = jan,
day = "1",
doi = "10.1016/j.resuscitation.2019.10.035",
language = "English (US)",
volume = "146",
pages = "82--95",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",
}