Abstract
Objective
To carry out a systematic review to estimate the rate and magnitude of adverse effects
following therapeutic hypothermia (TH) procedure in patients resuscitated from out-of-hospital
cardiac arrest (OHCA) and highlight the specific complications seen after the procedure.
Methods
A systematic review of currently published studies was performed following standard
guidelines. Online database searches were performed for controlled trials for the
last twenty years. Papers were examined for methodological soundness before being
included. Data were independently extracted by two blinded reviewers. Studies were
also assessed for bias using the Cochrane criteria. The adverse effects attributed
to TH in the literature were appraised critically.
Results
The initial data search yielded 78 potentially relevant studies; of these, 59 were
excluded for some reason. The main reason for exclusion (n = 43, 55.8%) was that irrelevance
to adverse effects of TH. Finally, 19 underwent full-text review. Studies were of
high-to-moderate (n = 12, 63%) to low-to-very low (n = 7, 37%) quality. Five studies
(27.7%) were found to have high risk of bias, while 8 (42.1%) had low risk of bias.
Interpretation
Although adverse effects related to the practice of TH have been studied extensively,
there is substantial heterogeneity between study populations and methodologies. There
is a considerable incidence of side effects attributed to the procedure, e.g., from
life-threatening ventricular arrhythmias to self-limited consequences. Most studies
analyzed in this systematic review indicated that the procedure of TH has not caused
severe adverse effects leading to significant alterations in the outcomes following
resuscitation from OHCA.
PROSPERO, registration number is: CRD42018075026.
Keywords
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Article Info
Publication History
Published online: July 12, 2018
Accepted:
July 10,
2018
Received in revised form:
June 27,
2018
Received:
March 21,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
