Therapeutic Hypothermia in Acute Ischemic Stroke-a Systematic Review and Meta-Analysis
PURPOSE OF REVIEW: Therapeutic hypothermia (TH) in stroke demonstrates robust neuroprotection in animals but clinical applications remain controversial. We assessed current literature on the efficacy of TH in ischemic stroke. RECENT FINDINGS: We conducted a meta-analysis comparing TH versus controls in studies published until June 2019. Controlled studies reporting on ≥ 10 adults with acute ischemic stroke were included. Primary outcome was functional independence (modified Rankin Scale [mRS] ≤ 2). Twelve studies (n = 351 TH, n = 427 controls) were included. Functional independence did not differ between groups (RR 1.17, 95% CI 0.93-1.46, random-effects p = 0.2). Five studies reported individual mRS outcomes and demonstrated a shift toward better outcome with TH (unadjusted cOR 1.57, 95% CI 1.01-2.44, p = 0.05). Overall complications were higher with TH (RR 1.18, 95% CI 1.06-1.32, p < 0.01). We did not observe an overall beneficial effect of TH in this analysis although some studies showed a shift toward better outcome. TH was associated with increased complications.
|Keywords||Ischemic stroke, Meta-analysis, Selective cooling, Systemic cooling, Therapeutic hypothermia|
|Persistent URL||dx.doi.org/10.1007/s11910-020-01029-3, hdl.handle.net/1765/126897|
|Journal||Current Neurology and Neuroscience Reports|
Kuczynski, A.M. (Andrea M.), Marzoughi, S. (Sina), Al Sultan, A.S. (Abdulaziz S.), Colbourne, F. (Frederick), Menon, B.K, van Es, A.C.G.M, … Almekhlafi, M. (2020). Therapeutic Hypothermia in Acute Ischemic Stroke-a Systematic Review and Meta-Analysis. Current Neurology and Neuroscience Reports (Vol. 20). doi:10.1007/s11910-020-01029-3