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Efficacy of Targeted Temperature Management after Pediatric Cardiac Arrest: A Meta-Analysis of 2002 Patients
Cardiac arrest (CA) is associated with high mortality and poor life quality. Targeted temperature management (TTM) or therapeutic hypothermia is a therapy increasing the survival of adult patients after CA. The study aim was to assess the feasibility of therapeutic hypothermia after pediatric CA. We...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037776/ https://www.ncbi.nlm.nih.gov/pubmed/33808425 http://dx.doi.org/10.3390/jcm10071389 |
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author | Wieczorek, Wojciech Meyer-Szary, Jarosław Jaguszewski, Milosz J. Filipiak, Krzysztof J. Cyran, Maciej Smereka, Jacek Gasecka, Aleksandra Ruetzler, Kurt Szarpak, Lukasz |
author_facet | Wieczorek, Wojciech Meyer-Szary, Jarosław Jaguszewski, Milosz J. Filipiak, Krzysztof J. Cyran, Maciej Smereka, Jacek Gasecka, Aleksandra Ruetzler, Kurt Szarpak, Lukasz |
author_sort | Wieczorek, Wojciech |
collection | PubMed |
description | Cardiac arrest (CA) is associated with high mortality and poor life quality. Targeted temperature management (TTM) or therapeutic hypothermia is a therapy increasing the survival of adult patients after CA. The study aim was to assess the feasibility of therapeutic hypothermia after pediatric CA. We performed a systematic review and meta-analysis of randomized controlled trials and observational studies evaluating the use of TTM after pediatric CA. The primary outcome was survival to hospital discharge or 30-day survival. Secondary outcomes included a one-year survival rate, survival with a Vineland adaptive behavior scale (VABS-II) score ≥ 70, and occurrence of adverse events. Ten articles (n = 2002 patients) were included, comparing TTM patients (n = 638) with controls (n = 1364). In a fixed-effects meta-analysis, survival to hospital discharge in the TTM group was 49.7%, which was higher than in the non-TTM group (43.5%; odds ratio, OR = 1.22; 95% confidence interval, CI: 1.00, 1.50; p = 0.06). There were no differences in the one-year survival rate or the occurrence of adverse events between the TTM and non-TTM groups. Altogether, the use of TTM was associated with a higher survival to hospital discharge; however, it did not significantly increase the annual survival. Additional high-quality prospective studies are necessary to confer additional TTM benefits. |
format | Online Article Text |
id | pubmed-8037776 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-80377762021-04-12 Efficacy of Targeted Temperature Management after Pediatric Cardiac Arrest: A Meta-Analysis of 2002 Patients Wieczorek, Wojciech Meyer-Szary, Jarosław Jaguszewski, Milosz J. Filipiak, Krzysztof J. Cyran, Maciej Smereka, Jacek Gasecka, Aleksandra Ruetzler, Kurt Szarpak, Lukasz J Clin Med Review Cardiac arrest (CA) is associated with high mortality and poor life quality. Targeted temperature management (TTM) or therapeutic hypothermia is a therapy increasing the survival of adult patients after CA. The study aim was to assess the feasibility of therapeutic hypothermia after pediatric CA. We performed a systematic review and meta-analysis of randomized controlled trials and observational studies evaluating the use of TTM after pediatric CA. The primary outcome was survival to hospital discharge or 30-day survival. Secondary outcomes included a one-year survival rate, survival with a Vineland adaptive behavior scale (VABS-II) score ≥ 70, and occurrence of adverse events. Ten articles (n = 2002 patients) were included, comparing TTM patients (n = 638) with controls (n = 1364). In a fixed-effects meta-analysis, survival to hospital discharge in the TTM group was 49.7%, which was higher than in the non-TTM group (43.5%; odds ratio, OR = 1.22; 95% confidence interval, CI: 1.00, 1.50; p = 0.06). There were no differences in the one-year survival rate or the occurrence of adverse events between the TTM and non-TTM groups. Altogether, the use of TTM was associated with a higher survival to hospital discharge; however, it did not significantly increase the annual survival. Additional high-quality prospective studies are necessary to confer additional TTM benefits. MDPI 2021-03-30 /pmc/articles/PMC8037776/ /pubmed/33808425 http://dx.doi.org/10.3390/jcm10071389 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Wieczorek, Wojciech Meyer-Szary, Jarosław Jaguszewski, Milosz J. Filipiak, Krzysztof J. Cyran, Maciej Smereka, Jacek Gasecka, Aleksandra Ruetzler, Kurt Szarpak, Lukasz Efficacy of Targeted Temperature Management after Pediatric Cardiac Arrest: A Meta-Analysis of 2002 Patients |
title | Efficacy of Targeted Temperature Management after Pediatric Cardiac Arrest: A Meta-Analysis of 2002 Patients |
title_full | Efficacy of Targeted Temperature Management after Pediatric Cardiac Arrest: A Meta-Analysis of 2002 Patients |
title_fullStr | Efficacy of Targeted Temperature Management after Pediatric Cardiac Arrest: A Meta-Analysis of 2002 Patients |
title_full_unstemmed | Efficacy of Targeted Temperature Management after Pediatric Cardiac Arrest: A Meta-Analysis of 2002 Patients |
title_short | Efficacy of Targeted Temperature Management after Pediatric Cardiac Arrest: A Meta-Analysis of 2002 Patients |
title_sort | efficacy of targeted temperature management after pediatric cardiac arrest: a meta-analysis of 2002 patients |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037776/ https://www.ncbi.nlm.nih.gov/pubmed/33808425 http://dx.doi.org/10.3390/jcm10071389 |
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