Sökning: onr:"swepub:oai:lup.lub.lu.se:a7705441-7b34-48ec-9184-3363dff985dd" > Higher versus lower...
Fältnamn | Indikatorer | Metadata |
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000 | 05502naa a2200541 4500 | |
001 | oai:lup.lub.lu.se:a7705441-7b34-48ec-9184-3363dff985dd | |
003 | SwePub | |
008 | 230911s2023 | |||||||||||000 ||eng| | |
024 | 7 | a https://lup.lub.lu.se/record/a7705441-7b34-48ec-9184-3363dff985dd2 URI |
024 | 7 | a https://doi.org/10.1016/j.resuscitation.2023.1098622 DOI |
040 | a (SwePub)lu | |
041 | a engb eng | |
042 | 9 SwePub | |
072 | 7 | a for2 swepub-publicationtype |
072 | 7 | a ref2 swepub-contenttype |
100 | 1 | a Niemelä, Villeu Helsinki University Central Hospital4 aut |
245 | 1 0 | a Higher versus lower blood pressure targets after cardiac arrest : Systematic review with individual patient data meta-analysis |
264 | 1 | c 2023 |
520 | a Purpose: Guidelines recommend targeting mean arterial pressure (MAP) > 65 mmHg in patients after cardiac arrest (CA). Recent trials have studied the effects of targeting a higher MAP as compared to a lower MAP after CA. We performed a systematic review and individual patient data meta-analysis to investigate the effects of higher versus lower MAP targets on patient outcome. Method: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, LILACS, BIOSIS, CINAHL, Scopus, the Web of Science Core Collection, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry, Google Scholar and the Turning Research into Practice database to identify trials randomizing patients to higher (≥71 mmHg) or lower (≤70 mmHg) MAP targets after CA and resuscitation. We used the Cochrane Risk of Bias tool, version 2 (RoB 2) to assess for risk of bias. The primary outcomes were 180-day all-cause mortality and poor neurologic recovery defined by a modified Rankin score of 4–6 or a cerebral performance category score of 3–5. Results: Four eligible clinical trials were identified, randomizing a total of 1,087 patients. All the included trials were assessed as having a low risk for bias. The risk ratio (RR) with 95% confidence interval for 180-day all-cause mortality for a higher versus a lower MAP target was 1.08 (0.92–1.26) and for poor neurologic recovery 1.01 (0.86–1.19). Trial sequential analysis showed that a 25% or higher treatment effect, i.e., RR < 0.75, can be excluded. No difference in serious adverse events was found between the higher and lower MAP groups. Conclusions: Targeting a higher MAP compared to a lower MAP is unlikely to reduce mortality or improve neurologic recovery after CA. Only a large treatment effect above 25% (RR < 0.75) could be excluded, and future studies are needed to investigate if relevant but lower treatment effect exists. Targeting a higher MAP was not associated with any increase in adverse effects. | |
650 | 7 | a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe |
650 | 7 | a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng |
653 | a Blood pressure | |
653 | a Cardiac arrest | |
653 | a Meta-analysis | |
653 | a Systematic review | |
653 | a Target | |
700 | 1 | a Siddiqui, Faizau Copenhagen University Hospital4 aut0 (Swepub:lu)med-fsq |
700 | 1 | a Ameloot, Koenu Hospital Oost-Limburg,Hasselt University,University Hospitals Leuven4 aut |
700 | 1 | a Reinikainen, Mattiu University of Eastern Finland4 aut |
700 | 1 | a Grand, Johannesu Copenhagen University Hospital4 aut |
700 | 1 | a Hästbacka, Johannau Tampere University Hospital4 aut |
700 | 1 | a Hassager, Christianu Copenhagen University Hospital4 aut |
700 | 1 | a Kjaergaard, Jesperu Copenhagen University Hospital4 aut |
700 | 1 | a Åneman, Andersu University of New South Wales4 aut |
700 | 1 | a Tiainen, Marjaanau Helsinki University Central Hospital4 aut |
700 | 1 | a Nielsen, Niklasu Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Kliniska Vetenskaper, Helsingborg,Institutionen för kliniska vetenskaper, Lund,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SEBRA Sepsis and Bacterial Resistance Alliance,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Sciences, Helsingborg,Department of Clinical Sciences, Lund,Center for cardiac arrest,Lund University Research Groups,Helsingborg Hospital,Clinical Studies Sweden-Forum South,Skåne University Hospital4 aut0 (Swepub:lu)med-nni |
700 | 1 | a Harboe Olsen, Markusu Skåne University Hospital,Copenhagen University Hospital4 aut |
700 | 1 | a Jorgensen, Caroline Kampu University of Southern Denmark,Copenhagen University Hospital4 aut |
700 | 1 | a Juul Petersen, Johanneu Copenhagen University Hospital4 aut |
700 | 1 | a Dankiewicz, Josefu Copenhagen University Hospital4 aut |
700 | 1 | a Saxena, Manoju University of New South Wales4 aut |
700 | 1 | a Jakobsen, Janus C.u University of Southern Denmark,Copenhagen University Hospital4 aut |
700 | 1 | a Skrifvars, Markus B.u Helsinki University Central Hospital4 aut |
710 | 2 | a Helsinki University Central Hospitalb Copenhagen University Hospital4 org |
773 | 0 | t Resuscitationg 189q 189x 0300-9572 |
856 | 4 | u http://dx.doi.org/10.1016/j.resuscitation.2023.109862x freey FULLTEXT |
856 | 4 8 | u https://lup.lub.lu.se/record/a7705441-7b34-48ec-9184-3363dff985dd |
856 | 4 8 | u https://doi.org/10.1016/j.resuscitation.2023.109862 |
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