Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024;31(5):740-747.
doi: 10.5603/CJ.a2022.0093. Epub 2022 Oct 6.

Should targeted temperature management be used in cardiogenic shock patients? Systematic review and meta-analysis

Adam Nieborek  1 , Jerzy R Ladny  2 , Milosz J Jaguszewski  3 , Andrea Denegri  4 , Aleksandra Sikora  5 , Szymon Pucylo  5 , Aleksandra Gasecka  5 , Michal Pruc  1 , Ivan Savytsky  6 , Lukasz Szarpak  7   8   9
Affiliations
Meta-Analysis

Should targeted temperature management be used in cardiogenic shock patients? Systematic review and meta-analysis

Adam Nieborek et al. Cardiol J. 2024.

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.

Keywords: cardiogenic shock; meta-analysis; outcome; targeted temeparature management; therapeutic hypothermia.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: Adam Nieborek — work for BARD Poland; all other authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram showing stages of the database search and study selection as per Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines
Figure 2
Figure 2
A summary table of review author judgements for each risk of bias item for randomized trials (A) and non--randomized trials (B)
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Vahdatpour C, Collins D, Goldberg S. Cardiogenic shock. J Am Heart Assoc. 2019;8(8):e011991. doi: 10.1161/JAHA.119.011991. - DOI - PMC - PubMed
    1. Adrie C, Laurent I, Monchi M, et al. Postresuscitation disease after cardiac arrest: a sepsis-like syndrome? Curr Opin Crit Care. 2004;10(3):208–212. doi: 10.1097/01.ccx.0000126090.06275.fe. - DOI - PubMed
    1. Brener MI, Rosenblum HR, Burkhoff D. Pathophysiology and advanced hemodynamic assessment of cardiogenic shock. Methodist Debakey Cardiovasc J. 2020;16(1):7–15. doi: 10.14797/mdcj-16-1-7. - DOI - PMC - PubMed
    1. Thiele H, Ohman EM, de Waha-Thiele S, et al. Management of cardiogenic shock complicating myocardial infarction: an update 2019. Eur Heart J. 2019;40(32):2671–2683. doi: 10.1093/eurheartj/ehz363. - DOI - PubMed
    1. Hochman JS, Sleeper LA, Webb JG, et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock. N Engl J Med. 1999;341(9):625–634. doi: 10.1056/NEJM199908263410901. - DOI - PubMed

MeSH terms

LinkOut - more resources