Efficacy of targeted temperature management after pediatric cardiac arrest: A meta-analysis of 2002 patients

Wojciech Wieczorek, Jarosław Meyer-Szary, Milosz J. Jaguszewski, Krzysztof J. Filipiak, Maciej Cyran, Jacek Smereka, Aleksandra Gasecka, Kurt Ruetzler, Lukasz Szarpak

Research output: Contribution to JournalReview articleAcademicpeer-review

Abstract

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% confi-dence 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.
Original languageEnglish
Article number1389
JournalJournal of Clinical Medicine
Volume10
Issue number7
DOIs
Publication statusPublished - 1 Apr 2021

Keywords

  • Controlled normothermia
  • Cooling
  • Meta-analysis
  • Outcome
  • Pe-diatric
  • Post-resuscitation care
  • Therapeutic hypothermia

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