Targeting low-normal or high-normal mean arterial pressure after cardiac arrest and resuscitation : a randomised pilot trial

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COMACARE Study Grp , Jakkula , P , Pettilä , V , Skrifvars , M B , Hästbacka , J , Loisa , P , Tiainen , M , Wilkman , E , Toppila , J , Koskue , T , Bendel , S , Birkelund , T , Laru-Sompa , R , Valkonen , M & Reinikainen , M 2018 , ' Targeting low-normal or high-normal mean arterial pressure after cardiac arrest and resuscitation : a randomised pilot trial ' , Intensive Care Medicine , vol. 44 , no. 12 , pp. 2091-2101 . https://doi.org/10.1007/s00134-018-5446-8

Title: Targeting low-normal or high-normal mean arterial pressure after cardiac arrest and resuscitation : a randomised pilot trial
Author: COMACARE Study Grp; Jakkula, Pekka; Pettilä, Ville; Skrifvars, Markus B.; Hästbacka, Johanna; Loisa, Pekka; Tiainen, Marjaana; Wilkman, Erika; Toppila, Jussi; Koskue, Talvikki; Bendel, Stepani; Birkelund, Thomas; Laru-Sompa, Raili; Valkonen, Miia; Reinikainen, Matti
Contributor: University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, HYKS erva
University of Helsinki, Neurologian yksikkö
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2018-12
Language: eng
Number of pages: 11
Belongs to series: Intensive Care Medicine
ISSN: 0342-4642
URI: http://hdl.handle.net/10138/285684
Abstract: PurposeWe aimed to determine the feasibility of targeting low-normal or high-normal mean arterial pressure (MAP) after out-of-hospital cardiac arrest (OHCA) and its effect on markers of neurological injury. MethodsIn the Carbon dioxide, Oxygen and Mean arterial pressure After Cardiac Arrest and REsuscitation (COMACARE) trial, we used a 2(3) factorial design to randomly assign patients after OHCA and resuscitation to low-normal or high-normal levels of arterial carbon dioxide tension, to normoxia or moderate hyperoxia, and to low-normal or high-normal MAP. In this paper we report the results of the low-normal (65-75mmHg) vs. high-normal (80-100mmHg) MAP comparison. The primary outcome was the serum concentration of neuron-specific enolase (NSE) at 48h after cardiac arrest. The feasibility outcome was the difference in MAP between the groups. Secondary outcomes included S100B protein and cardiac troponin (TnT) concentrations, electroencephalography (EEG) findings, cerebral oxygenation and neurological outcome at 6months after cardiac arrest.ResultsWe recruited 123 patients and included 120 in the final analysis. We found a clear separation in MAP between the groups (p
Subject: Arterial pressure
Cardiac arrest
Intensive care
Neuron-specific enolase (NSE)
Hypoxic ischemic encephalopathy
Mechanical ventilation
THERAPEUTIC HYPOTHERMIA
COMATOSE SURVIVORS
BLOOD-PRESSURE
INDUCED HYPERTENSION
OUTCOMES
AUTOREGULATION
HEMODYNAMICS
IMPACT
EEG
3126 Surgery, anesthesiology, intensive care, radiology
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