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Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation

Overview of attention for article published in Cochrane database of systematic reviews, February 2016
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (95th percentile)
  • Good Attention Score compared to outputs of the same age and source (77th percentile)

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3 blogs
policy
1 policy source
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25 X users
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6 Facebook pages
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6 Wikipedia pages
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1 Google+ user

Citations

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179 Dimensions

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571 Mendeley
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Title
Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation
Published in
Cochrane database of systematic reviews, February 2016
DOI 10.1002/14651858.cd004128.pub4
Pubmed ID
Authors

Jasmin Arrich, Michael Holzer, Christof Havel, Marcus Müllner, Harald Herkner

Abstract

Good neurological outcome after cardiac arrest is difficult to achieve. Interventions during the resuscitation phase and treatment within the first hours after the event are critical. Experimental evidence suggests that therapeutic hypothermia is beneficial, and several clinical studies on this topic have been published. This review was originally published in 2009; updated versions were published in 2012 and 2016. We aimed to perform a systematic review and meta-analysis to assess the influence of therapeutic hypothermia after cardiac arrest on neurological outcome, survival and adverse events. We searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 10); MEDLINE (1971 to May 2015); EMBASE (1987 to May 2015); the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1988 to May 2015); and BIOSIS (1989 to May 2015). We contacted experts in the field to ask for information on ongoing, unpublished or published trials on this topic.The original search was performed in January 2007. We included all randomized controlled trials (RCTs) conducted to assess the effectiveness of therapeutic hypothermia in participants after cardiac arrest, without language restrictions. We restricted studies to adult populations cooled by any cooling method, applied within six hours of cardiac arrest. We entered validity measures, interventions, outcomes and additional baseline variables into a database. Meta-analysis was performed only for a subset of comparable studies with negligible heterogeneity. We assessed the quality of the evidence by using standard methodological procedures as expected by Cochrane and incorporated the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach. We found six RCTs (1412 participants overall) conducted to evaluate the effects of therapeutic hypothermia - five on neurological outcome and survival, one on only neurological outcome. The quality of the included studies was generally moderate, and risk of bias was low in three out of six studies. When we compared conventional cooling methods versus no cooling (four trials; 437 participants), we found that participants in the conventional cooling group were more likely to reach a favourable neurological outcome (risk ratio (RR) 1.94, 95% confidence interval (CI) 1.18 to 3.21). The quality of the evidence was moderate.Across all studies that used conventional cooling methods rather than no cooling (three studies; 383 participants), we found a 30% survival benefit (RR 1.32, 95% CI 1.10 to 1.65). The quality of the evidence was moderate.Across all studies, the incidence of pneumonia (RR 1.15, 95% CI 1.02 to 1.30; two trials; 1205 participants) and hypokalaemia (RR 1.38, 95% CI 1.03 to 1.84; two trials; 975 participants) was slightly increased among participants receiving therapeutic hypothermia, and we observed no significant differences in reported adverse events between hypothermia and control groups. Overall the quality of the evidence was moderate (pneumonia) to low (hypokalaemia). Evidence of moderate quality suggests that conventional cooling methods provided to induce mild therapeutic hypothermia improve neurological outcome after cardiac arrest, specifically with better outcomes than occur with no temperature management. We obtained available evidence from studies in which the target temperature was 34°C or lower. This is consistent with current best medical practice as recommended by international resuscitation guidelines for hypothermia/targeted temperature management among survivors of cardiac arrest. We found insufficient evidence to show the effects of therapeutic hypothermia on participants with in-hospital cardiac arrest, asystole or non-cardiac causes of arrest.

X Demographics

X Demographics

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 571 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 4 <1%
Brazil 2 <1%
United Kingdom 2 <1%
Chile 1 <1%
Canada 1 <1%
Netherlands 1 <1%
Spain 1 <1%
New Zealand 1 <1%
Unknown 558 98%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 80 14%
Student > Master 69 12%
Researcher 65 11%
Other 58 10%
Student > Ph. D. Student 42 7%
Other 118 21%
Unknown 139 24%
Readers by discipline Count As %
Medicine and Dentistry 274 48%
Nursing and Health Professions 65 11%
Psychology 13 2%
Neuroscience 11 2%
Agricultural and Biological Sciences 9 2%
Other 46 8%
Unknown 153 27%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 42. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 July 2023.
All research outputs
#992,554
of 25,457,297 outputs
Outputs from Cochrane database of systematic reviews
#1,976
of 11,499 outputs
Outputs of similar age
#18,600
of 413,078 outputs
Outputs of similar age from Cochrane database of systematic reviews
#49
of 222 outputs
Altmetric has tracked 25,457,297 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,499 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 40.0. This one has done well, scoring higher than 83% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 413,078 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 95% of its contemporaries.
We're also able to compare this research output to 222 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 77% of its contemporaries.