Endovaskuläre Kühlung oder Oberflächenkühlung?

Fink, Katrin; Schwab, Tilmann; Bode, Ch.; Busch, Hans-Jörg

doi:10.1007/s00101-008-1464-1

Cited by 9 publications

(4 citation statements)

References 29 publications

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“…This left a total of 14 studies for the final meta-analysis. Four of these studies were RCTs (29–32), and the other 10 studies were retrospective and prospective observational studies (22, 33–41) ( Supplemental Table 2 , http://links.lww.com/CCM/H8; legend, http://links.lww.com/CCM/H12).…”

Section: Resultsmentioning

confidence: 99%

“…One study (38) did not report information concerning temperature feedback in 685 patients leaving 3,377 patients for final analysis in our NMA. Overall, 1,160 patients (34%) from 12 studies (22, 29, 31–38, 40, 41) were cooled with intravascular cooling methods and 2,217 patients (66%) from 14 studies (22, 29–41) were cooled with surface cooling methods. Of the 2,217 patients cooled with surface cooling methods, 512 patients from nine studies (30–32, 34, 36, 38–41) were cooled with temperature feedback (23% of patients with surface cooling and 15% of all patients) and 1,705 patients from seven studies (22, 29, 30, 33, 35, 37, 39) were cooled without temperature feedback (77% of patients with surface cooling and 50% of all patients).…”

Section: Resultsmentioning

confidence: 99%

“…There are only few single studies specifically comparing intravascular cooling with surface cooling with temperature feedback (22, 29, 31–38, 40, 41). The majority of these studies showed that there may be a trend for improved neurologic outcome in patients cooled with intravascular cooling compared with surface cooling with temperature feedback.…”

Section: Discussionmentioning

confidence: 99%

“…From studies partially included in the other meta-analysis (4–7), we excluded seven studies due to unclear information on temperature feedback (10, 19, 49–53), and further six studies due to critical risk of bias (23–28). As opposed to our meta-analysis, eight studies (29, 30, 33, 35–39) were not included in the other meta-analyses (4–7) and seven studies (29, 30, 33, 35, 37–39) for unknown reasons and one study (36) due to language restrictions. A detailed comparison table of included and excluded studies of the previous meta-analyses as compared with our meta-analysis is shown in Supplemental Table 3 (http://links.lww.com/CCM/H10; legend, http://links.lww.com/CCM/H12) and Supplemental Table 4 (http://links.lww.com/CCM/H11; legend, http://links.lww.com/CCM/H12).…”

Section: Discussionmentioning

confidence: 99%

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Intravascular Versus Surface Cooling in Patients Resuscitated From Cardiac Arrest: A Systematic Review and Network Meta-Analysis With Focus on Temperature Feedback

Ramadanov

Arrich

Klein³

et al. 2022

Critical Care Medicine

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OBJECTIVE: The aim of the study was to compare the effect of intravascular cooling (IC), surface cooling with temperature feedback (SCF), and surface cooling without temperature feedback (SCnoF) on neurologic outcome and survival in patients successfully resuscitated from cardiac arrest (CA) and treated with targeted temperature management (TTM) at 32–34°C. DATA SOURCES: We performed a systematic review on Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, MEDLINE, SCOPUS, CINAHL, Web of Science, and Clinical Trials up to June 30, 2021. STUDY SELECTION: We included randomized and nonrandomized studies on IC, SCF, and SCnoF in adult humans resuscitated from CA undergoing TTM, reporting neurologic outcome or survival. DATA EXTRACTION: We performed a network meta-analysis to assess the comparative effects of IC, SCF, and SCnoF. The overall effect between two cooling methods included the effect of direct and indirect comparisons. Results are given as odds ratios (OR) and 95% CIs. Rankograms estimated the probability of TTM methods being ranked first, second, and third best interventions. DATA SYNTHESIS: A total of 14 studies involving 4,062 patients met the inclusion criteria. Four studies were randomized controlled studies, and 10 studies were nonrandomized observational studies. IC compared with SCnoF was significantly associated with better neurologic outcome (OR, 0.6; 95% CI, 0.49–0.74) and survival (OR, 0.8; 95% CI, 0.66–0.96). IC compared with SCF, and SCF compared with SCnoF did not show significant differences in neurologic outcome and survival. The rankogram showed that IC had the highest probability to be the most beneficial cooling method, followed by SCF and SCnoF. CONCLUSIONS: Our results suggest that in patients resuscitated from CA and treated with TTM at 32–34°C, IC has the highest probability of being the most beneficial cooling method for survival and neurologic outcome.

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Section: Resultsmentioning

confidence: 99%