Oxygen targets and 6-month outcome after out of hospital cardiac arrest: a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial
| العنوان: | Oxygen targets and 6-month outcome after out of hospital cardiac arrest: a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial |
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| المؤلفون: | Chiara Robba, Rafael Badenes, Denise Battaglini, Lorenzo Ball, Filippo Sanfilippo, Iole Brunetti, Janus Christian Jakobsen, Gisela Lilja, Hans Friberg, Pedro David Wendel-Garcia, Paul J. Young, Glenn Eastwood, Michelle S. Chew, Johan Unden, Matthew Thomas, Michael Joannidis, Alistair Nichol, Andreas Lundin, Jacob Hollenberg, Naomi Hammond, Manoj Saxena, Annborn Martin, Miroslav Solar, Fabio Silvio Taccone, Josef Dankiewicz, Niklas Nielsen, Anders Morten Grejs, Florian Ebner, Paolo Pelosi, TTM2 Trial collaborators, Erik Roman-Pognuz |
| المساهمون: | Robba, Chiara, Badenes, Rafael, Battaglini, Denise, Ball, Lorenzo, Filippo, Sanfilippo, Brunetti, Iole, Christian Jakobsen, Janu, Lilja, Gisela, Friberg, Han, David Wendel-Garcia, Pedro, Young, Paul J., Eastwood, Glenn, Chew, Michelle S., Unden, Johan, Thomas, Matthew, Joannidis, Michael, Nichol, Alistair, Lundin, Andrea, Hollenberg, Jacob, Hammond, Naomi, Saxena, Manoj, Martin, Annborn, Solar, Miroslav, Silvio Taccone, Fabio, Dankiewicz, Josef, Nielsen, Nikla, Morten Grejs, Ander, Ebner, Florian, Pelosi, Paolo, Trial collaborators, Ttm2, ROMAN-POGNUZ, Erik |
| المصدر: | Robba, C, Badenes, R, Battaglini, D, Ball, L, Sanfilippo, F, Brunetti, I, Jakobsen, J C, Lilja, G, Friberg, H, Wendel-Garcia, P D, Young, P J, Eastwood, G, Chew, M S, Unden, J, Thomas, M, Joannidis, M, Nichol, A, Lundin, A, Hollenberg, J, Hammond, N, Saxena, M, Martin, A, Solar, M, Taccone, F S, Dankiewicz, J, Nielsen, N, Grejs, A, Ebner, F, Pelosi, P & TTM2 Trial collaborators 2022, ' Oxygen targets and 6-month outcome after out of hospital cardiac arrest : a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial ', Critical Care, vol. 26, 323 . https://doi.org/10.1186/s13054-022-04186-8Test Critical care (London, England) r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA instname |
| بيانات النشر: | Springer Science and Business Media LLC, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Male, Anestesi och intensivvård, Anesthesiology and Intensive Care, Cardiac arrest, Hypoxemia, Hyperoxemia, Mortality, Neurological outcome, Partial Pressure, Hypothermia, Middle Aged, Critical Care and Intensive Care Medicine, Oxygen, Humans, Female, Hypoxia, Out-of-Hospital Cardiac Arrest, Aged |
| الوصف: | Background Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO2) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO2 with patients’ outcome. Methods Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO2 2 > 300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. Results 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93–1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95–1.06). The time exposure, i.e., the area under the curve (PaO2-AUC), for hyperoxemia was significantly associated with mortality (p = 0.003). Conclusions In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. Trial registration: clinicaltrials.gov NCT02908308, Registered September 20, 2016. |
| وصف الملف: | application/pdf; ELETTRONICO |
| تدمد: | 1364-8535 1466-609X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5bb9bcd61d180f9d6542108cb086d25aTest https://doi.org/10.1186/s13054-022-04186-8Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....5bb9bcd61d180f9d6542108cb086d25a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13648535 1466609X |
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