Lindsay PJ, et al. - The efficacy, as well as safety of initiating pre-hospital therapeutic hypothermia (TH) in patients with out-of-hospital cardiac arrest (OHCA), was determined in this systematic review and meta-analysis using data from all available randomised controlled trials (RCTs). As a result of pre-hospital TH after OHCA, an effective decrease in body temperature was noted at the time of hospital arrival but no improvement was seen in rates of survival with good neurological outcome or overall survival. Also, pre-hospital TH after OHCA was found to be related to increased rates of re-arrest.