Related Experiment Video
Updated: Apr 15, 2026
In vitro Assessment of Myocardial Protection following Hypothermia-Preconditioning in a Human Cardiac Myocytes Model
Published on: October 27, 2020
Therapeutic hypothermia in children after cardiac arrest: a systematic review and meta-analysis
Janice F Bistritz1, Lauren M Horton, Arlene Smaldone
1From Columbia University School of Nursing, New York, NY.
Insights
Therapeutic hypothermia (TH) shows limited evidence for pediatric resuscitation. While mortality rates were observed, neurologic outcomes and adverse events like electrolyte imbalances and pneumonia require further investigation in children.
Area of Science:
- Pediatric Critical Care Medicine
- Neonatal Resuscitation
- Neurology
Background:
- Therapeutic hypothermia (TH) is established for adult cardiac arrest and infant hypoxic ischemic encephalopathy.
- Limited research exists on TH efficacy and safety in pediatric populations.
Purpose of the Study:
- To systematically review and meta-analyze mortality, neurologic outcomes, and adverse events associated with TH in children.
- To assess the current evidence base for TH in pediatric resuscitation.
Main Methods:
- Systematic review and meta-analysis of studies from 1946-2014.
- Inclusion of 6 studies (3 retrospective, 3 prospective cohort).
- Quantitative synthesis of mortality and neurologic outcomes in 136 pediatric subjects.
Main Results:
- Overall mortality following TH in children was 44% (95% CI, 32-57).
- Poor neurologic outcome was observed in 28% (95% CI, 11-53) of survivors.
- Common adverse events included electrolyte imbalances and pneumonia.
Conclusions:
- Insufficient evidence supports TH over normothermia for pediatric resuscitation.
- The adverse event profile in children may differ from adults.
- Further research is necessary to establish TH as a standard pediatric protocol.
Background:
Therapeutic hypothermia (TH) has been shown to be effective in resuscitation of some adults following cardiac arrest and infants with hypoxic ischemic encephalopathy, but has not been well studied in children.
Objectives:
The purpose of this systematic review/meta-analysis was to examine mortality, neurologic outcomes, and adverse events in children following use of TH.
Results:
A search of PubMed, the Cumulative Index to Nursing and Allied Health Literature, and the Institute for Scientific Information's Web of Knowledge from 1946 to 2014 yielded 6 studies (3 retrospective and 3 prospective cohort studies) that met our inclusion criteria. Quantitative synthesis of mortality following TH (136 subjects) was 44% (95% confidence interval, 32-57) with 28% (95% confidence interval, 11-53) of survivors (42 subjects) demonstrating poor neurologic outcome. The most frequently reported adverse events were electrolyte imbalances and pneumonia.
Conclusions:
Evidence is insufficient to support the advantage of TH compared with normothermia in pediatric resuscitation. The adverse event profile appears to be different than that reported in adults. Further studies are needed before TH may be considered a standard protocol for children after cardiac arrest.
