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Sökning: onr:"swepub:oai:lup.lub.lu.se:a7705441-7b34-48ec-9184-3363dff985dd" > Higher versus lower...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00005502naa a2200541 4500
001oai:lup.lub.lu.se:a7705441-7b34-48ec-9184-3363dff985dd
003SwePub
008230911s2023 | |||||||||||000 ||eng|
0247 a https://lup.lub.lu.se/record/a7705441-7b34-48ec-9184-3363dff985dd2 URI
0247 a https://doi.org/10.1016/j.resuscitation.2023.1098622 DOI
040 a (SwePub)lu
041 a engb eng
042 9 SwePub
072 7a for2 swepub-publicationtype
072 7a ref2 swepub-contenttype
1001 a Niemelä, Villeu Helsinki University Central Hospital4 aut
2451 0a Higher versus lower blood pressure targets after cardiac arrest : Systematic review with individual patient data meta-analysis
264 1c 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 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650 7a 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
7001 a Siddiqui, Faizau Copenhagen University Hospital4 aut0 (Swepub:lu)med-fsq
7001 a Ameloot, Koenu Hospital Oost-Limburg,Hasselt University,University Hospitals Leuven4 aut
7001 a Reinikainen, Mattiu University of Eastern Finland4 aut
7001 a Grand, Johannesu Copenhagen University Hospital4 aut
7001 a Hästbacka, Johannau Tampere University Hospital4 aut
7001 a Hassager, Christianu Copenhagen University Hospital4 aut
7001 a Kjaergaard, Jesperu Copenhagen University Hospital4 aut
7001 a Åneman, Andersu University of New South Wales4 aut
7001 a Tiainen, Marjaanau Helsinki University Central Hospital4 aut
7001 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
7001 a Harboe Olsen, Markusu Skåne University Hospital,Copenhagen University Hospital4 aut
7001 a Jorgensen, Caroline Kampu University of Southern Denmark,Copenhagen University Hospital4 aut
7001 a Juul Petersen, Johanneu Copenhagen University Hospital4 aut
7001 a Dankiewicz, Josefu Copenhagen University Hospital4 aut
7001 a Saxena, Manoju University of New South Wales4 aut
7001 a Jakobsen, Janus C.u University of Southern Denmark,Copenhagen University Hospital4 aut
7001 a Skrifvars, Markus B.u Helsinki University Central Hospital4 aut
7102 a Helsinki University Central Hospitalb Copenhagen University Hospital4 org
7730 t Resuscitationg 189q 189x 0300-9572
8564 u http://dx.doi.org/10.1016/j.resuscitation.2023.109862x freey FULLTEXT
8564 8u https://lup.lub.lu.se/record/a7705441-7b34-48ec-9184-3363dff985dd
8564 8u https://doi.org/10.1016/j.resuscitation.2023.109862

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