Systematic review and network meta-analysis of non-pharmacological interventions for inadequate perfusion in hypothermic circulatory arrest

This network meta-analysis aimed to compare different non-pharmacological interventions for insufficient perfusion after hypothermic circulatory arrest, a key technique in aortic arch surgery. The authors retrieved and analyzed 60 eligible studies from four databases up to July 2025. The results showed that moderate hypothermia combined with specific cerebral perfusion strategies achieved better overall outcomes. Moderate hypothermia generally improved multiple clinical indicators without affecting several complications, and different perfusion approaches and cannulation methods had comparable effects. This work helps surgeons select optimal interventions and improve patient prognosis after aortic arch surgery.