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Cochrane Database of Systematic Reviews

Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation

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Information

DOI:
https://doi.org/10.1002/14651858.CD004128.pub2Copy DOI
Database:
  1. Cochrane Database of Systematic Reviews
Version published:
  1. 07 October 2009see what's new
Type:
  1. Intervention
Stage:
  1. Review
Cochrane Editorial Group:
  1. Cochrane Anaesthesia Group

Copyright:
  1. Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Authors

  • Jasmin Arrich

    Correspondence to: Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria

    [email protected]

  • Michael Holzer

    Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria

  • Harald Herkner

    Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria

  • Marcus Müllner

    AGES PharmMed, Austrian Medicines and Medical Devices Agency, Vienna, Austria

Contributions of authors

Conceiving the review: Harald Herkner (HH), Michael Holzer (MH), Marcus Müllner (MM)
Co‐ordinating the review: HH, MM
Undertaking manual searches: MH, Jasmin Arrich (JA)
Screening search results: MH, JA
Organizing retrieval of papers: JA
Screening retrieved papers against inclusion criteria: MH, JA, MM
Appraising quality of papers: MH, HH, JA, MM
Abstracting data from papers: MH, JA
Writing to authors of papers for additional information: MH
Providing additional data about papers: MH
Obtaining and screening data on unpublished studies: MH, JA
Data management for the review: JA, MM
Entering data into Review Manager (RevMan 5): MH, JA
RevMan statistical data: HH, MM, JA
Other statistical analyses not using RevMan: HH, MM
Double entry of data: MH, JA
Interpretation of data: MH, HH, JA, MM
Statistical inferences: HH, MM, JA
Writing the review: JA, MM, HH
Securing funding for the review: not applicable
Performing previous work that was the foundation of the present study: MM, MH
Guarantor for the review (one author): JA
Person responsible for reading and checking review before submission: HH

Sources of support

Internal sources

  • Medical University of Vienna, Austria.

External sources

  • No sources of support supplied

Declarations of interest

The Medical University of Vienna received an unrestricted scientific grant from Alsius Corporation for an independent scientific project, which was used for financing the post of Jasmin Arrich.
Michael Holzer received travel grants for scientific conferences from Alsius Corporation and Kinetic Concepts, Inc (KCI) and honoraria for lectures from Medivance and KCI. He is member of the scientific advisory board of KCI.

Marcus Müllner and Michael Holzer were involved in the design, conduct and publication of the HACA 2002 trial.

Harald Herknerno conflicts of interest.

Acknowledgements

We would like to thank Dr Mathew Zacharias (content editor), Dr Marialena Trivella (statistical editor) and Dr Malcolm G Booth, Dr George Djaiani and Shafi Mussa (peer reviewers) for their help and editorial advice during the preparation of this review.

We would also like to thank Dr Mathew Zacharias, Dr Marialena Trivella, Dr Malcolm Booth, Dr Karen Rees, Prof. Ian Jacobs and Jane Cracknell for their help and editorial advice during the preparation of the protocol for the review.

Version history

Published

Title

Stage

Authors

Version

2023 May 22

Hypothermia for neuroprotection in adults after cardiac arrest

Review

Jasmin Arrich, Nikola Schütz, Julia Oppenauer, Janne Vendt, Michael Holzer, Christof Havel, Harald Herkner

https://doi.org/10.1002/14651858.CD004128.pub5

2016 Feb 15

Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation

Review

Jasmin Arrich, Michael Holzer, Christof Havel, Marcus Müllner, Harald Herkner

https://doi.org/10.1002/14651858.CD004128.pub4

2012 Sep 12

Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation

Review

Jasmin Arrich, Michael Holzer, Christof Havel, Marcus Müllner, Harald Herkner

https://doi.org/10.1002/14651858.CD004128.pub3

2009 Oct 07

Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation

Review

Jasmin Arrich, Michael Holzer, Harald Herkner, Marcus Müllner

https://doi.org/10.1002/14651858.CD004128.pub2

2009 Jul 08

Hypothermia for neuroprotection after cardiopulmonary resuscitation

Protocol

Jasmin Arrich, Stephen Bernard, Michael Holzer, Risto Roine

https://doi.org/10.1002/14651858.CD004128

Differences between protocol and review

In our protocol we aimed to include additional endpoints like the six months and final CPC score, long‐term mortality, quality of life at six months, long‐term dependency, and cost‐effectiveness. The retrieved studies did not provide any information on long‐term mortality and dependency, quality of life, or cost effectiveness.

All studies that were included in the individual patient analysis provided data on both best and final neurologic outcome (Bernard 2002; HACA 2002; Hachimi‐Idrissi 2001). In our opinion the "best neurological score during hospital stay" is superior to the final score as the final score may be influenced by other factors like worsening of body functions or re‐arrests.

Bernard 2002 and Hachimi‐Idrissi 2001gave information on survival to hospital discharge, HACA 2002 additionally on the six‐months survival, Laurent 2005 only gave information on the six‐months survival. As the study by Laurent was not included in the individual patients analysis we chose survival to hospital discharge as a secondary endpoint for the individual patient analysis.

The documentation of adverse effects were overlooked in the original protocol. As they form a vital part of every review we included them in the data extraction sheet before we performed the literature search.

In accordance with our reviewers to better explain the reasons for dual analysis and the way it was carried out we have changed the wording of the objectives from:

"The aim of this study is to present a systematic review of the literature and, if applicable, a meta‐analysis, concerning the neuroprotective effect of induced hypothermia in primary cardiac arrest survivors. We plan to use data at the aggregate (study) level and the individual (patient) level."

to:

"We aimed to perform a systematic review and meta‐analysis to assess the effectiveness of therapeutic hypothermia in patients after cardiac arrest. Neurologic outcome, survival and adverse events were our main outcome parameters. We aimed to perform individual patient data analysis if data were available. We intended to form subgroups according to the cardiac arrest situation."

The title has been changed from "Hypothermia for neuroprotection after cardiopulmonary resuscitation" to "Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation".

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.