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

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

Artikel/kapitelEngelska2022

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2022-07-02
Springer Science and Business Media LLC,2022
15 s.

Nummerbeteckningar

LIBRIS-ID:oai:lup.lub.lu.se:a50ab512-d45c-4abd-956e-1c9203b6f1ad
https://lup.lub.lu.se/record/a50ab512-d45c-4abd-956e-1c9203b6f1adURI
https://doi.org/10.1007/s00134-022-06756-4DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-187443URI
http://kipublications.ki.se/Default.aspx?queryparsed=id:150136910URI
https://gup.ub.gu.se/publication/319106URI

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Språk:engelska
Sammanfattning på:engelska

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Ämneskategori:ref swepub-contenttype

Anmärkningar

Funding Agencies|Universita degli Studi di Genova; Swedish Research Council [Vetenskapsradet]; Swedish Heart-Lung Foundation; Stig and Ragna Gorthon Foundation; Knutsson Foundation; Laerdal Foundation; Hans-Gabriel and Alice Trolle-Wachtmeister Foundation for Medical Research; Region Skane; Swedish National Health Service
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 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
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

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

Badenes, RafaelUniversity of Valencia,Valencia University Hospital,Hosp Clin Univ Valencia, Spain; Univ Valencia, Spain (författare)
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,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(Swepub:lu)efor-hfr (författare)
Chew, Michelle S.Linköpings universitet,Linköping University,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Region Östergötland, ANOPIVA US(Swepub:liu)micch61 (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(Swepub:lu)neur-jun (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)
Annborn, MartinLund 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(Swepub:lu)med-ma2 (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,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(Swepub:lu)med-nni (författare)
Pelosi, PaoloOspedale Policlinico San Martino,University of Genoa,San Martino Policlin Hosp, Italy; Univ Genoa, Italy (författare)
Ullén, SusannSkåne University Hospital(Swepub:lu)su7040ul (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,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(Swepub:lu)ores-hal (creator_code:cre_t)
Nordberg, PerKarolinska Institute(Swepub:lu)pe5482no (creator_code:cre_t)
Palmér, KarolinaRegion Skåne(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)
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,Univ Libre Bruxelles, Belgium(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, ErikSkåne 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, GustavRegion Skåne(Swepub:lu)efor-gma (creator_code:cre_t)
Persson, OlofSkåne University Hospital(Swepub:lu)slju-olp (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)
Andertun, SaraHelsingborg Hospital(Swepub:lu)sa7042an (creator_code:cre_t)
Ebner, FlorianHelsingborg Hospital(Swepub:lu)med-foe (creator_code:cre_t)
Johnsson, JesperKarolinska Institutet(Swepub:lu)eng06jjo (creator_code:cre_t)
Battaglini, DeniseSan Martino Policlin Hosp, Italy; Univ Barcelona, Spain (författare)
Ball, LorenzoSan Martino Policlin Hosp, Italy; Univ Genoa, Italy (författare)
Brunetti, IoleSan Martino Policlin Hosp, Italy (författare)
Jakobsen, Janus C.Copenhagen Univ Hosp, Denmark; Univ Southern Denmark, Denmark (författare)
Wendel-Garcia, Pedro D.Univ Hosp Zurich, Switzerland (författare)
Eastwood, GlennAustin Hosp, Australia (författare)
Thomas, MatthewUniv Hosp Bristol NHS Fdn Trust, England (författare)
Joannidis, MichaelMed Univ Innsbruck, Austria (författare)
Nichol, AlistairMonash Univ, Australia (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)
University of GenoaOspedale Policlinico San Martino (creator_code:org_t)
on behalf of the TTM2 Trial Collaborators

Sammanhörande titlar

Ingår i:Intensive Care Medicine: Springer Science and Business Media LLC48:8, s. 1024-10380342-46421432-1238

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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...

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