Therapeutische Hypothermie (TH) - Repository of the LBI-HTA ...

Executive Summary
Background and research question
Mild therapeutic hypothermia (TH), that is cooling down of the body temperature
to around 32-34°C, has been recommended for patients after successful
resuscitation from cardiac arrest. It aims at improving neurological
outcomes and reducing mortality. Due to promising results, its indications
are evolving continuously although some are still considered experimental.
This report gives an overview of the best available evidence of therapeutic
hypothermia for 11 different indications in adult patients.
TH 32-34°C is
recommended after
cardiac arrest
evidence overview for 11
indications
Methods
We conducted a multistage, systematic literature search that aimed at identifying
the best available evidence for each indication. At first, we searched
for Cochrane reviews, which yielded 23 results. Then, we searched for systematic
reviews (other than Cochrane reviews) in three databases and identified
77 publications. Finally, we searched for clinical trials in three databases,
which yielded 440 results. In addition, we searched for ongoing or
completed trials in three study registries. Furthermore, we conducted an unsystematic
hand search (websites, reference lists, etc.). Two researchers independently
selected the literature and included or excluded selected studies.
One review author extracted the data and a second author controlled the
completeness and accuracy of the extracted data. In case of disagreement, we
reached consensus through discussion or by involving a third person.
multistage, systematic
literature search for
- Cochrane reviews
- SR
- clinical trials
literature selection,
inclusion and exclusion
by 2 authors
Results
We identified 14 studies (in 15 publications) of therapeutic hypothermia for
ten different indications, four of which were Cochrane reviews related to
three indications (cardiac arrest, stroke, traumatic brain injury). Moreover,
we found one randomised controlled trial and one non-randomised controlled
trial evaluating different target temperatures for one indication (sepsis).
In addition, we identified five prospective case-series and one systematic
review of prospective case-series for four indications (cardiogenic shock,
refractory fever, meningitis/meningoencephalitis, acute liver failure), two
publications of one retrospective case-series (spinal cord injury) as well as
one publication of single case reports (status epilepticus). For one indication
(acute kidney injury) we found neither published literature, nor ongoing or
completed studies.
14 studies for 10
indications
- 4 Cochrane reviews
- 1 RCT
- 1 CCT
- 7 case-series
(pro/retro)
- 1 case report
0 publications for acute
kidney injury
LBI-HTA | 2012 9