Ventilatory settings in the initial 72 h and their association with outcome in out-of-hospital cardiac arrest patients : a preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest (TTM2) trial

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Ventilatory settings in the initial 72 h and their association with outcome in out-of-hospital cardiac arrest patients : a preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest (TTM2) trial

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

Badenes, Rafael (författare): University of Valencia,Valencia University Hospital,Hosp Clin Univ Valencia, Spain; Univ Valencia, Spain

Lilja, Gisela (författare): 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

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Friberg, Hans (författare): Lund University,Lunds universitet,Lund University Bioimaging Center,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Lund Univ, Sweden

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

Unden, Johan (författare): 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

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

Annborn, Martin (författare): Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund Univ, Sweden

Dankiewicz, Josef (författare): 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 (författare): Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lund University Bioimaging Center,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SEBRA Sepsis and Bacterial Resistance Alliance,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Lund Univ, Sweden

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

Ullén, Susann (författare): Skåne University Hospital

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,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups

Nordberg, Per (creator_code:cre_t): Karolinska Institute

Palmér, Karolina (creator_code:cre_t): Region Skåne

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

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,Univ Libre Bruxelles, Belgium

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): 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): Region Skåne

Persson, Olof (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

Andertun, Sara (creator_code:cre_t): Helsingborg Hospital

Ebner, Florian (creator_code:cre_t): Helsingborg Hospital

Johnsson, Jesper (creator_code:cre_t): Karolinska Institutet

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

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

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

Jakobsen, Janus C. (författare): Copenhagen Univ Hosp, Denmark; Univ Southern Denmark, Denmark

Wendel-Garcia, Pedro D. (författare): Univ Hosp Zurich, Switzerland

Eastwood, Glenn (författare): Austin Hosp, Australia

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

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

Nichol, Alistair (författare): Monash Univ, Australia

Hollenberg, Jacob (författare): Karolinska Inst, Sweden

Hammond, Naomi (författare): UNSW Sydney, Australia

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

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

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(creator_code:org_t)

2022-07-02
2022
Engelska 15 s.
Ingår i: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 48:8, s. 1024-1038

Relaterad länk:: http://dx.doi.org/10... (free); visa fler...; https://liu.diva-por... (primary) (Raw object); https://lup.lub.lu.s...; https://doi.org/10.1...; https://urn.kb.se/re...; http://kipublication...; https://gup.ub.gu.se...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

Purpose: The optimal ventilatory settings in patients after cardiac arrest and their association with outcome remain unclear. The aim of this study was to describe the ventilatory settings applied in the first 72 h of mechanical ventilation in patients after out-of-hospital cardiac arrest and their association with 6-month outcomes. Methods: Preplanned sub-analysis of the Target Temperature Management-2 trial. Clinical outcomes were mortality and functional status (assessed by the Modified Rankin Scale) 6 months after randomization. Results: A total of 1848 patients were included (mean age 64 [Standard Deviation, SD = 14] years). At 6 months, 950 (51%) patients were alive and 898 (49%) were dead. Median tidal volume (VT) was 7 (Interquartile range, IQR = 6.2–8.5) mL per Predicted Body Weight (PBW), positive end expiratory pressure (PEEP) was 7 (IQR = 5–9) cmH20, plateau pressure was 20 cmH20 (IQR = 17–23), driving pressure was 12 cmH20 (IQR = 10–15), mechanical power 16.2 J/min (IQR = 12.1–21.8), ventilatory ratio was 1.27 (IQR = 1.04–1.6), and respiratory rate was 17 breaths/minute (IQR = 14–20). Median partial pressure of oxygen was 87 mmHg (IQR = 75–105), and partial pressure of carbon dioxide was 40.5 mmHg (IQR = 36–45.7). Respiratory rate, driving pressure, and mechanical power were independently associated with 6-month mortality (omnibus p-values for their non-linear trajectories: p < 0.0001, p = 0.026, and p = 0.029, respectively). Respiratory rate and driving pressure were also independently associated with poor neurological outcome (odds ratio, OR = 1.035, 95% confidence interval, CI = 1.003–1.068, p = 0.030, and OR = 1.005, 95% CI = 1.001–1.036, p = 0.048). A composite formula calculated as [(4*driving pressure) + respiratory rate] was independently associated with mortality and poor neurological outcome. Conclusions: Protective ventilation strategies are commonly applied in patients after cardiac arrest. Ventilator settings in the first 72 h after hospital admission, in particular driving pressure and respiratory rate, may influence 6-month outcomes.

Ämnesord

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)

Nyckelord

Cardiac arrest
Driving pressure
Mechanical power
Mechanical ventilation
Outcome
Ventilator settings
Mechanical ventilation; Cardiac arrest; Outcome; Mechanical power; Driving pressure; Ventilator settings
respiratory-distress-syndrome
intensive-care units
therapeutic
hypothermia
carbon-dioxide
lung injury
metaanalysis
mortality
pressure
management
oxygen
General & Internal Medicine

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Av författaren/redakt...: Robba, Chiara; Badenes, Rafael; Lilja, Gisela; Friberg, Hans; Chew, Michelle S ...; Unden, Johan; visa fler...; Lundin, Andreas; Annborn, Martin; Dankiewicz, Jose ...; Nielsen, Niklas; Pelosi, Paolo; Ullén, Susann; Cronberg, Tobias; Erlinge, David; Levin, Helena; Nordberg, Per; Palmér, Karolina; Karlsson, Ulla B ...; Heissler, Simon; Ceric, Ameldina; Haxhija, Zana; Düring, Joachim; Bergström, Matti ...; 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 ...; Persson, Olof; Rundgren, Malin; Westhall, Erik; Andertun, Sara; Ebner, Florian; Johnsson, Jesper; Battaglini, Deni ...; Ball, Lorenzo; Brunetti, Iole; Jakobsen, Janus ...; Wendel-Garcia, P ...; Eastwood, Glenn; Thomas, Matthew; Joannidis, Micha ...; Nichol, Alistair; Hollenberg, Jaco ...; Hammond, Naomi; Saxena, Manoj; Solar, Miroslav; visa färre...

Om ämnet

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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Av lärosätet: Lunds universitet; Linköpings universitet; Karolinska Institutet; Göteborgs universitet

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