Targeted temperature management (TTM) is a standard of care in patients after cardiac arrest for neuroprotection. The effects of TTM on patients after ECPR is unknown. We aimed to compare neurological and survival outcomes between TTM vs non-TTM in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest.

Of 5784 studies screened, 24 observational studies met inclusion criteria. These encompassed 1509 patients undergoing ECPR, of whom 948 (63%) underwent TTM. The median age was 55 years (interquartile range: 42-72) with 1168 (77%) males. There was no difference in good neurological outcome at any time between TTM (29%, 95% confidence interval [CI]: 19%-40%) vs non-TTM (34%, 95% CI: 13%-58%) after ECPR (p=0.6). Similarly, survival at any time between TTM (33%, 95% CI: 24%-42%) and non-TTM (35%, 95% CI: 24%-47%) was not different (p=0.7). Bleeding complications between TTM (28%, 95% CI: 12%-47%) vs non-TTM (49%, 95% CI: 25%-73%) did not differ (p=0.05).