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Related Experiment Video

Updated: Oct 6, 2025

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Therapeutic Hypothermia Is Associated With a Decrease in All-cause Mortality in Cardiac Arrest Due to Shockable

Usama Nasir1, Shivaraj Nagalli2, Tayyab Ali Waheed3

  • 1From the Department of Internal Medicine, Reading Hospital-Tower Health, Reading, PA.

Critical Pathways in Cardiology
|January 20, 2022
PubMed
Summary

Therapeutic hypothermia (TH) did not significantly reduce mortality or poor neurological outcomes in all comatose cardiac arrest patients. However, TH showed benefits for patients with shockable rhythms, reducing mortality and improving neurological outcomes.

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Area of Science:

  • Critical Care Medicine
  • Cardiology
  • Neurology

Background:

  • The efficacy of therapeutic hypothermia (TH) for comatose patients following cardiac arrest is debated.
  • Previous studies have yielded conflicting results regarding TH's benefits.

Purpose of the Study:

  • To investigate the outcomes of therapeutic hypothermia in comatose patients post-cardiac arrest.
  • To pool data from randomized controlled trials to clarify the benefits of TH.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted.
  • Searched electronic databases up to September 21, 2021, for RCTs comparing TH (32-34 °C) with normothermia (≥36 °C) in comatose cardiac arrest survivors.
  • Included 10 RCTs with 3988 participants.

Main Results:

  • Overall, TH did not significantly reduce all-cause mortality (OR, 0.83; 95% CI, 0.66-1.05) or poor neurological outcomes (OR, 0.78; 95% CI, 0.61-1.01).
  • Subgroup analysis revealed a significant reduction in all-cause mortality (OR, 0.55; 95% CI, 0.37-0.80) and poor neurological outcomes (OR, 0.48; 95% CI, 0.32-0.72) in patients with shockable rhythms.
  • No significant heterogeneity was observed in the shockable rhythm subgroup (I2 = 0%).

Conclusions:

  • Therapeutic hypothermia may be beneficial for comatose patients post-cardiac arrest, specifically those with shockable rhythms.
  • TH demonstrated a potential to decrease mortality and improve neurological function in this specific patient subgroup.