Yu Tao, Longhini Federico, Wu Rongrong, Yao Weidong, Lu Weihua, Jin Xiaoju
Department of Anaesthesiology and Intensive Care Unit, Wannan Medical College, Yijishan Hospital, Wuhu, Anhui, China.
Department of Translational Medicine, Eastern Piedmont University 'A. Avogadro', Novara, Italy.
J Int Med Res. 2015 Aug;43(4):471-82. doi: 10.1177/0300060515576010. Epub 2015 May 26.
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.
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.
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.
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.
确定心脏骤停后恢复自主循环（ROSC）的患者接受轻度低温治疗与未接受轻度低温治疗相比，死亡率和神经功能结局是否得到改善。
对2014年3月之前发表的英文随机对照试验进行在线数据库检索，比较心脏骤停后恢复自主循环的成年患者中轻度低温（32 - 34℃）与正常体温或非轻度低温的低温治疗。使用专用表格独立提取数据。记录总体人群以及院内和院外轻度低温亚组的死亡率和神经功能结局。
确定7篇文章纳入荟萃分析。轻度低温在总体死亡率或神经功能结局方面未显示出显著有益效果。此外，院外和院内亚组之间未观察到显著的结局差异。
基于这一有限数据集，轻度低温并不能改善心脏骤停后恢复自主循环患者的死亡率或神经功能结局，无论低温治疗的时机如何。需要进行更大规模的试验来证实这些发现。
