Should Targeted Temperature Management Be Used in Cardiogenic Shock Patients? Systematic Review and Meta-Analysis

Authors

Adam Nieborek
Jerzy R Ladny
Milosz J Jaguszewski
Andrea Denegri
Aleksandra Sikora
Szymon Pucylo
Aleksandra Gasecka
Michal Pruc
Ivan Savytsky
Lukasz Szarpak

Publication Date

1-1-2024

Journal

Journal of Cardiology

DOI

10.5603/CJ.a2022.0093

PMID

36200546

PMCID

PMC11544404

PubMedCentral® Posted Date

10-30-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Shock, Cardiogenic, Hypothermia, Induced, Treatment Outcome, Risk Factors, targeted temeparature management, therapeutic hypothermia, cardiogenic shock, outcome, meta-analysis

Abstract

BACKGROUND: Therapeutic hypothermia, or targeted temperature management (TTM), is a strategy of reducing the core body temperature of survivors of sudden cardiac arrest, cardiogenic shock (CS) or stroke. Therefore, a systematic literature review and meta-analysis were performed to tackle the question about whether the implementation of TTM is actually beneficial for patients with CS.

METHODS: Study was designed as a systematic review and meta-analysis. PubMed, Cochrane Library, Web of Science and Scopus were searched from these databases inception to July 17, 2022. Eligible studies were those comparing TTM and non-TTM treatment in CS patients. Data were pooled with the Mantel-Haenszel method.

RESULTS: Thirty-day mortality was reported in 3 studies. Polled analysis of 30-day mortality was 44.2% for TTM group and 48.9% for non-TTM group (risk ratio: 0.90; 95% confidence interval: 0.75 to 1.08; p = 0.27). Other mortality follow-up periods showed also no statistically significant differences (p > 0.05). The occurrence of adverse events in the studied groups also did not show statistically significant differences between TTM and non-TTM groups (p > 0.05 for myocardial infarction, stent thrombosis, sepsis, pneumonia, stroke or bleeding events).

CONCLUSIONS: The present analysis shows no significant benefit of TTM in patients with CS. Moreover, no statistically significant increase of the incidence of adverse effects was found. However, further randomized studies with higher sample size and greater validity are needed to determine if TTM is worth implementing in CS patients.