Temperature Management in Patients After Cardiac Arrest

Two systematic reviews (1 with a network meta-analysis and 1 with a meta-analysis), 1 randomized controlled trial, and 7 non-randomized studies were identified about the comparative clinical effectiveness of normothermia versus hypothermia in adult patients after cardiac arrest. Normothermia was found to be similar to hypothermia for several clinical- and patient-related outcomes, such as survival, hospital mortality, and quality of life. There was limited evidence to suggest that either type of targeted temperature management was more efficacious, with findings suggesting that normothermia may be associated with greater protocol adherence and decreased prescription medication use coming from low-quality non-randomized studies. Four evidence-based guidelines were identified regarding targeted temperature management (normothermia or hypothermia) in adult patients after cardiac arrest. All guidelines strongly recommend targeted temperature management for eligible patients, particularly for patients resuscitated following out-of-hospital cardiac arrest. Identified guidelines from the Canadian Cardiovascular Society and American Academy of Neurology present strong recommendations for hypothermic targeted temperature management.