Hipotermia terapéutica extrahospitalaria. Una revisión sistemática

Resumen

Recent studies have demonstrated therapeutic mild hypothermia improves neurological outcome of patients after suffering an out-of-hospital cardiac arrest. Other studies in animals suggest that the sooner hypothermia is started after return of spontaneous circulation, the lower neurological symptoms are suffered by patients. The aim of this work is to know the efficiency of the therapeutic moderated hipotermia after the cardiopulmonar resuscitation realized extra hospitable. Methods: We made a literature search in Medline (Pubmed), Cinahl, Cuiden, Cochrane Library and the Joanna Briggs Institute, combining mesh and free terms; and searched in the journals Circulation, Resuscitation and Emergency Medicine Journal manually last year. We selected systematic reviews and randomized and nonrandomized clinical trials which had contrasted in-hospital and out-of-hospital TMH with over 18 years patients. Results: Only 5 articles met the inclusion criteria of the 35 selected: four randomized clinical trials and one nonrandomized. They were then subjected to a critical methodological evaluation (CASPe) and statistic evaluation (IDIPaz). Conclusions: Pre hospital TMH is an effective and safe technique in comatose patients after being resuscitated from cardiac arrest, improving the neurological status at hospital discharge.