TARGETED TEMPERATURE MANAGEMENT IN OUT-OF-HOSPITAL CARDIAC ARREST PATIENTS: A SYSTEMATIC LITERATURE REVIEW

Abstract

Background Targeted temperature management (also known as 'therapeutic hypothermia', 'induced hypothermia', or 'cooling') is beneficial in patients who have had successful resuscitation from cardiac arrest in out-of-hospital conditions. Still, it remains unclear when or under what specific conditions this intervention should be initiated. The uncertainty surrounding the outcomes of OHCA TTM interventions has attracted the attention of researchers applying diverse methodological research intervention variants. Neurological and survival outcomes are identified as the most observed outcomes of such interventions. However, a lack of research consensus about the primary versus secondary focus remains. Objectives To assess the effects of target temperature management on the neurological and survival outcomes in out-of-hospital adult cardiac arrest patients on a broad scope of applicable hypothermic interventions based on the control of cooling, its onset, duration, and any additional therapies for a hybrid intervention administered under randomised comparative trial designs. Search Methods The data was searched and collected from online databases, namely Web of Science (WOS), PubMed Central (PMC), Medline, Embase, Cochrane, and Google Scholar. Selection Criteria I searched for randomised comparative trials (Including randomised controlled trials, randomised clinical trials, and other randomised comparative trial studies, such as randomised post hoc studies or retrospective studies based on large trial registries, that applied TTM interventions on adult OHCA patients. I looked primarily for neurological and survival outcomes.

Data Collection and Analysis I used a data screening, collection, and extraction procedure based on the search criteria. I followed a primarily qualitative synthesis of the quantitative results of the included studies. Main Results Overall, 21 studies across an aggregate of 11435 participants, with a median sample of 355, did not show sufficient qualitatively assessed quantitative and qualitative evidence for the relative safety, feasibility, efficiency, and efficacy of the TTM interventional variants for OHCA patients, on neurological and mortality outcomes.