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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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

Robba, Chiara (author): University of Genoa,San Martino Policlin Hosp, Italy; Univ Genoa, Italy

Lilja, Gisela (author): Lund 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

Friberg, Hans (author): Lund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Center for cardiac arrest,Lund University Research Groups,Lund Univ, Sweden

Chew, Michelle S. (author): Linköpings universitet,Linköping University,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Region Östergötland, ANOPIVA US,Skåne University Hospital

Unden, Johan (author): Lund 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

Dankiewicz, Josef (author): Lund 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

Nielsen, Niklas (author): Lund 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

Ebner, Florian (author): Lund 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

Pelosi, Paolo (author): University of Genoa,San Martino Policlin Hosp, Italy; Univ Genoa, Italy

Cronberg, Tobias (creator_code:cre_t): Lund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Brain Injury After Cardiac Arrest,Center for cardiac arrest,Lund University Research Groups

Erlinge, David (creator_code:cre_t): Lund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups

Levin, Helena (creator_code:cre_t): Lund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Center for cardiac arrest,Lund University Research Groups

Nordberg, Per (creator_code:cre_t): Lund 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

Ullén, Susann (creator_code:cre_t): Lund 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

Palmér, Karolina (creator_code:cre_t): Lund University,Lunds universitet,Allmänmedicin och klinisk epidemiologi,Forskargrupper vid Lunds universitet,Family Medicine and Clinical Epidemiology,Lund University Research Groups

Karlsson, Ulla Britt (creator_code:cre_t): Lund 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

Heissler, Simon (creator_code:cre_t): Lund 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

Ceric, Ameldina (creator_code:cre_t): Helsingborg Hospital

Haxhija, Zana (creator_code:cre_t): Helsingborg Hospital

Düring, Joachim (creator_code:cre_t): Skåne University Hospital

Bergström, Mattias (creator_code:cre_t): Skåne University Hospital

Bohm, Mattias (creator_code:cre_t): Skåne University Hospital

Didriksson, Ingrid (creator_code:cre_t): Skåne University Hospital

Frid, Petrea (creator_code:cre_t): Skåne University Hospital

Heimburg, Katarina (creator_code:cre_t): Skåne University Hospital

Lundberg, Oscar (creator_code:cre_t): Skåne University Hospital

Hau, Stefan Olsson (creator_code:cre_t): Skåne University Hospital

Schmidbauer, Simon (creator_code:cre_t): Skåne University Hospital

Borgquist, Ola (creator_code:cre_t): Skåne University Hospital

Bjärnroos, Anna (creator_code:cre_t): Skåne University Hospital

Blennow Nordström, Erik (creator_code:cre_t): Lund 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

Dragancea, Irina (creator_code:cre_t): Skåne University Hospital

Kander, Thomas (creator_code:cre_t): Skåne University Hospital

Lybeck, Anna (creator_code:cre_t): Skåne University Hospital

Mattiasson, Gustav (creator_code:cre_t): Skåne University Hospital

Rundgren, Malin (creator_code:cre_t): Skåne University Hospital

Westhall, Erik (creator_code:cre_t): Skåne University Hospital

Annborn, Martin (creator_code:cre_t): Helsingborg Hospital,Lund Univ, Sweden

Andertun, Sara (creator_code:cre_t): Helsingborg Hospital

Johnsson, Jesper (creator_code:cre_t): Karolinska Institutet

Unden, Johan (creator_code:cre_t): Helsingborg Hospital

Wijdicks, Eelco F. M. (creator_code:cre_t)

Badenes, Rafael (author): Univ Valencia, Spain; Univ Valencia, Spain

Battaglini, Denise (author): San Martino Policlin Hosp, Italy; Univ Barcelona, Spain

Ball, Lorenzo (author): San Martino Policlin Hosp, Italy; Univ Genoa, Italy

Sanfilippo, Filippo (author): AOU Policlin San Marco, Italy

Brunetti, Iole (author): San Martino Policlin Hosp, Italy

Jakobsen, Janus Christian (author): Copenhagen Univ Hosp, Denmark; Univ Southern Denmark, Denmark

Wendel-Garcia, Pedro David (author): Univ Hosp Zurich, Switzerland

Eastwood, Glenn (author): Monash Univ, Australia; Austin Hosp, Australia

Thomas, Matthew (author): Univ Hosp Bristol NHS Fdn Trust, England

Joannidis, Michael (author): Med Univ Innsbruck, Austria

Nichol, Alistair (author): Monash Univ, Australia

Lundin, Andreas (author): Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care

Hollenberg, Jacob (author): Karolinska Inst, Sweden

Hammond, Naomi (author): UNSW Sydney, Australia

Saxena, Manoj (author): St George Hosp, Australia

Solar, Miroslav (author): Charles Univ Prague, Czech Republic; Univ Hosp Hradec Kralove, Czech Republic

Taccone, Fabio Silvio (author): Univ Libre Bruxelles, Belgium

Grejs, Anders Morten (author): Aarhus Univ Hosp, Denmark; Aarhus Univ, Denmark

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(creator_code:org_t)

2022-10-21
2022
English.
In: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535 .- 1466-609X. ; 26, s. 1-13

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Journal article (peer-reviewed)

Abstract Subject headings

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.

Subject headings

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)

Keyword

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

Publication and Content Type

art (subject category)
ref (subject category)

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By the author/editor: Robba, Chiara; Lilja, Gisela; Friberg, Hans; Chew, Michelle S ...; Unden, Johan; Dankiewicz, Jose ...; show more...; 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 ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Anesthesiology a ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...

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