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Stroke Research and Treatment
Volume 2012 (2012), Article ID 295906, 12 pages
http://dx.doi.org/10.1155/2012/295906
Research Article

Application of Mild Therapeutic Hypothermia on Stroke: A Systematic Review and Meta-Analysis

Department of Biosciences, Global Neuroscience Initiative Foundation, Los Angeles, Panorama City, P.O. Box 4832 CA 91412, USA

Received 27 October 2011; Accepted 6 December 2011

Academic Editor: Chelsea S. Kidwell

Copyright © 2012 Shaheen E. Lakhan and Fabricio Pamplona. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Stroke occurs due to an interruption in cerebral blood supply affecting neuronal function. Body temperature on hospital admission is an important predictor of clinical outcome. Therapeutic hypothermia is promising in clinical settings for stroke neuroprotection. Methods. MEDLINE/PubMed, CENTRAL, Stroke Center, and ClinicalTrials.gov were systematically searched for hypothermia intervention induced by external or endovascular cooling for acute stroke. NIH Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were the main stroke scales used, and mortality was also reported. A meta-analysis was carried out on stroke severity and mortality. Results. Seven parallel-controlled clinical trials were included in the meta-analysis. Sample sizes ranged from 18 to 62 patients, yielding a total of 288. Target temperature (~33°C) was reached within 3-4 hours. Stroke severity (Cohen's 𝑑 = 0 . 1 7 , 95% CI: −0.42 to 0.08, 𝑃 = 0 . 3 2 ; I2  = 73%; Chi2 = 21.89, 𝑃 = 0 . 0 0 0 1 ) and mortality ( R R = 1 . 6 0 , 95% CI: 0.93 to 2.78, 𝑃 = 0 . 1 1 ; I 2 = 0%; Chi2 = 2.88, 𝑃 = 0 . 7 2 ) were not significantly affected by hypothermia. Discussion. Hypothermia does not significantly improve stroke severity; however, this finding should be taken with caution due to the high heterogeneity and limited number of included studies. No impact on mortality was observed.