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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Robba, ChiaraUniversity of Genoa,San Martino Policlin Hosp, Italy; Univ Genoa, Italy (författare)

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

Artikel/kapitelEngelska2022

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2022-10-21
Springer Science and Business Media LLC,2022

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LIBRIS-ID:oai:lup.lub.lu.se:4949a1e5-f4a6-4606-88ef-9290ff027aee
https://lup.lub.lu.se/record/4949a1e5-f4a6-4606-88ef-9290ff027aeeURI
https://doi.org/10.1186/s13054-022-04186-8DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-189768URI
http://kipublications.ki.se/Default.aspx?queryparsed=id:150994898URI
https://gup.ub.gu.se/publication/322298URI

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Språk:engelska
Sammanfattning på:engelska

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Funding Agencies|Swedish Research Council [Vetenskapsradet]; Swedish Heart-Lung Foundation; Knutsson Foundation; Stig and Ragna Gorthon Foundation; Laerdal Foundation; Hans-Gabriel and Alice Trolle-Wachtmeister Foundation for Medical Research; Regional Research Support in Region Skane); Swedish National Health Service
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 < 60 mmHg and severe hyperoxemia as PaO2 > 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.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Anestesi och intensivvård hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Anesthesiology and Intensive Care hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine hsv//eng
Cardiac arrest
Hyperoxemia
Hypoxemia
Mortality
Neurological outcome
Cardiac arrest; Hypoxemia; Hyperoxemia; Mortality; Neurological outcome
arterial oxygen
carbon-dioxide
hyperoxia
resuscitation
association
cardiopulmonary
survival
care
prognostication
epidemiology
General & Internal Medicine

Biuppslag (personer, institutioner, konferenser, titlar ...)

Lilja, GiselaLund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Brain Injury After Cardiac Arrest,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital,Lund Univ, Sweden(Swepub:lu)med-gal (författare)
Friberg, HansLund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Center for cardiac arrest,Lund University Research Groups,Lund Univ, Sweden(Swepub:lu)efor-hfr (författare)
Chew, Michelle S.Linköpings universitet,Linköping University,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Region Östergötland, ANOPIVA US,Skåne University Hospital(Swepub:lu)med-ss16 (författare)
Unden, JohanLund University,Lunds universitet,Anestesiologi och intensivvård,Forskargrupper vid Lunds universitet,Anaesthesiology and Intensive Care Medicine,Lund University Research Groups,Halmstad County Hospital,Lund Univ, Sweden; Lund Univ, Sweden,Helsingborg Hospital(Swepub:lu)neur-jun (författare)
Dankiewicz, JosefLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Sweden(Swepub:lu)med-jfd (författare)
Nielsen, NiklasLund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SEBRA Sepsis and Bacterial Resistance Alliance,Center for cardiac arrest,Lund University Research Groups,Helsingborg Hospital,Lund Univ, Sweden(Swepub:lu)med-nni (författare)
Ebner, FlorianLund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Kliniska Vetenskaper, Helsingborg,Institutionen för kliniska vetenskaper, Lund,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Sciences, Helsingborg,Department of Clinical Sciences, Lund,Helsingborg Hospital,Lund Univ, Sweden(Swepub:lu)med-foe (författare)
Pelosi, PaoloUniversity of Genoa,San Martino Policlin Hosp, Italy; Univ Genoa, Italy (författare)
Cronberg, TobiasLund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Brain Injury After Cardiac Arrest,Center for cardiac arrest,Lund University Research Groups(Swepub:lu)efor-tcr (creator_code:cre_t)
Erlinge, DavidLund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups(Swepub:lu)kard-der (creator_code:cre_t)
Levin, HelenaLund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Center for cardiac arrest,Lund University Research Groups(Swepub:lu)ores-hal (creator_code:cre_t)
Nordberg, PerLund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)pe5482no (creator_code:cre_t)
Ullén, SusannLund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)su7040ul (creator_code:cre_t)
Palmér, KarolinaLund University,Lunds universitet,Allmänmedicin och klinisk epidemiologi,Forskargrupper vid Lunds universitet,Family Medicine and Clinical Epidemiology,Lund University Research Groups(Swepub:lu)med-klc (creator_code:cre_t)
Karlsson, Ulla BrittLund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)med-ukn (creator_code:cre_t)
Heissler, SimonLund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)med-shi (creator_code:cre_t)
Ceric, AmeldinaHelsingborg Hospital(Swepub:lu)am1280bi (creator_code:cre_t)
Haxhija, ZanaHelsingborg Hospital(Swepub:lu)za1517ha (creator_code:cre_t)
Düring, JoachimSkåne University Hospital(Swepub:lu)jo3421du (creator_code:cre_t)
Bergström, MattiasSkåne University Hospital(Swepub:lu)ma2685be (creator_code:cre_t)
Bohm, MattiasSkåne University Hospital(Swepub:lu)ma7548bo (creator_code:cre_t)
Didriksson, IngridSkåne University Hospital(Swepub:lu)in5403di (creator_code:cre_t)
Frid, PetreaSkåne University Hospital(Swepub:lu)med-ptf (creator_code:cre_t)
Heimburg, KatarinaSkåne University Hospital(Swepub:lu)ka7876he (creator_code:cre_t)
Lundberg, OscarSkåne University Hospital(Swepub:lu)os0356lu (creator_code:cre_t)
Hau, Stefan OlssonSkåne University Hospital(Swepub:lu)med-sos (creator_code:cre_t)
Schmidbauer, SimonSkåne University Hospital(Swepub:lu)med-ss16 (creator_code:cre_t)
Borgquist, OlaSkåne University Hospital(Swepub:lu)med-oab (creator_code:cre_t)
Bjärnroos, AnnaSkåne University Hospital(Swepub:lu)an3572bj (creator_code:cre_t)
Blennow Nordström, ErikLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)er0251bl (creator_code:cre_t)
Dragancea, IrinaSkåne University Hospital(Swepub:lu)med-idn (creator_code:cre_t)
Kander, ThomasSkåne University Hospital(Swepub:lu)med-tkn (creator_code:cre_t)
Lybeck, AnnaSkåne University Hospital(Swepub:lu)med-aly (creator_code:cre_t)
Mattiasson, GustavSkåne University Hospital(Swepub:lu)efor-gma (creator_code:cre_t)
Rundgren, MalinSkåne University Hospital(Swepub:lu)med-mrg (creator_code:cre_t)
Westhall, ErikSkåne University Hospital(Swepub:lu)med-erw (creator_code:cre_t)
Annborn, MartinHelsingborg Hospital,Lund Univ, Sweden(Swepub:lu)med-ma2 (creator_code:cre_t)
Andertun, SaraHelsingborg Hospital(Swepub:lu)sa7042an (creator_code:cre_t)
Johnsson, JesperKarolinska Institutet(Swepub:lu)eng06jjo (creator_code:cre_t)
Unden, JohanHelsingborg Hospital(Swepub:lu)neur-jun (creator_code:cre_t)
Wijdicks, Eelco F. M. (creator_code:cre_t)
Badenes, RafaelUniv Valencia, Spain; Univ Valencia, Spain (författare)
Battaglini, DeniseSan Martino Policlin Hosp, Italy; Univ Barcelona, Spain (författare)
Ball, LorenzoSan Martino Policlin Hosp, Italy; Univ Genoa, Italy (författare)
Sanfilippo, FilippoAOU Policlin San Marco, Italy (författare)
Brunetti, IoleSan Martino Policlin Hosp, Italy (författare)
Jakobsen, Janus ChristianCopenhagen Univ Hosp, Denmark; Univ Southern Denmark, Denmark (författare)
Wendel-Garcia, Pedro DavidUniv Hosp Zurich, Switzerland (författare)
Eastwood, GlennMonash Univ, Australia; Austin Hosp, Australia (författare)
Thomas, MatthewUniv Hosp Bristol NHS Fdn Trust, England (författare)
Joannidis, MichaelMed Univ Innsbruck, Austria (författare)
Nichol, AlistairMonash Univ, Australia (författare)
Lundin, AndreasGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care(Swepub:gu)xlandz (författare)
Hollenberg, JacobKarolinska Inst, Sweden (författare)
Hammond, NaomiUNSW Sydney, Australia (författare)
Saxena, ManojSt George Hosp, Australia (författare)
Solar, MiroslavCharles Univ Prague, Czech Republic; Univ Hosp Hradec Kralove, Czech Republic (författare)
Taccone, Fabio SilvioUniv Libre Bruxelles, Belgium (författare)
Grejs, Anders MortenAarhus Univ Hosp, Denmark; Aarhus Univ, Denmark (författare)
University of GenoaSan Martino Policlin Hosp, Italy; Univ Genoa, Italy (creator_code:org_t)
TTM2 Trial collaborators

Sammanhörande titlar

Ingår i:Critical Care: Springer Science and Business Media LLC26, s. 1-131364-85351466-609X

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Av författaren/redakt...: Robba, Chiara; Lilja, Gisela; Friberg, Hans; Chew, Michelle S ...; Unden, Johan; Dankiewicz, Jose ...; visa fler...; Nielsen, Niklas; Ebner, Florian; Pelosi, Paolo; Cronberg, Tobias; Erlinge, David; Levin, Helena; Nordberg, Per; Ullén, Susann; Palmér, Karolina; Karlsson, Ulla B ...; Heissler, Simon; Ceric, Ameldina; Haxhija, Zana; Düring, Joachim; Bergström, Matti ...; Bohm, Mattias; Didriksson, Ingr ...; Frid, Petrea; Heimburg, Katari ...; Lundberg, Oscar; Hau, Stefan Olss ...; Schmidbauer, Sim ...; Borgquist, Ola; Bjärnroos, Anna; Blennow Nordströ ...; Dragancea, Irina; Kander, Thomas; Lybeck, Anna; Mattiasson, Gust ...; Rundgren, Malin; Westhall, Erik; Annborn, Martin; Andertun, Sara; Johnsson, Jesper; Wijdicks, Eelco ...; Badenes, Rafael; Battaglini, Deni ...; Ball, Lorenzo; Sanfilippo, Fili ...; Brunetti, Iole; Jakobsen, Janus ...; Wendel-Garcia, P ...; Eastwood, Glenn; Thomas, Matthew; Joannidis, Micha ...; Nichol, Alistair; Lundin, Andreas; Hollenberg, Jaco ...; Hammond, Naomi; Saxena, Manoj; Solar, Miroslav; Taccone, Fabio S ...; Grejs, Anders Mo ...; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Anestesi och int ...

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin

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