Targeting two different levels of both arterial carbon dioxide and arterial oxygen after cardiac arrest and resuscitation : a randomised pilot trial

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COMACARE Study Grp , Jakkula , P , Reinikainen , M , Hästbacka , J , Loisa , P , Tiainen , M , Pettilä , V , Toppila , J , Lähde , M , Bäcklund , M , Okkonen , M , Bendel , S , Birkelund , T , Pulkkinen , A , Heinonen , J , Tikka , T & Skrifvars , M B 2018 , ' Targeting two different levels of both arterial carbon dioxide and arterial oxygen after cardiac arrest and resuscitation : a randomised pilot trial ' , Intensive Care Medicine , vol. 44 , no. 12 , pp. 2112-2121 . https://doi.org/10.1007/s00134-018-5453-9

Title: Targeting two different levels of both arterial carbon dioxide and arterial oxygen after cardiac arrest and resuscitation : a randomised pilot trial
Author: COMACARE Study Grp; Jakkula, Pekka; Reinikainen, Matti; Hästbacka, Johanna; Loisa, Pekka; Tiainen, Marjaana; Pettilä, Ville; Toppila, Jussi; Lähde, Marika; Bäcklund, Minna; Okkonen, Marjatta; Bendel, Stepani; Birkelund, Thomas; Pulkkinen, Anni; Heinonen, Jonna; Tikka, Tuukka; Skrifvars, Markus B.
Contributor: University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, HYKS erva
University of Helsinki, Neurologian yksikkö
University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HYKS erva
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, Department of Diagnostics and Therapeutics
Date: 2018-12
Language: eng
Number of pages: 10
Belongs to series: Intensive Care Medicine
ISSN: 0342-4642
URI: http://hdl.handle.net/10138/285685
Abstract: PurposeWe assessed the effects of targeting low-normal or high-normal arterial carbon dioxide tension (PaCO2) and normoxia or moderate hyperoxia after out-of-hospital cardiac arrest (OHCA) on markers of cerebral and cardiac injury.MethodsUsing a 2(3) factorial design, we randomly assigned 123 patients resuscitated from OHCA to low-normal (4.5-4.7kPa) or high-normal (5.8-6.0kPa) PaCO2 and to normoxia (arterial oxygen tension [PaO2] 10-15kPa) or moderate hyperoxia (PaO2 20-25kPa) and to low-normal or high-normal mean arterial pressure during the first 36h in the intensive care unit. Here we report the results of the low-normal vs. high-normal PaCO2 and normoxia vs. moderate hyperoxia comparisons. The primary endpoint was the serum concentration of neuron-specific enolase (NSE) 48h after cardiac arrest. Secondary endpoints included S100B protein and cardiac troponin concentrations, continuous electroencephalography (EEG) and near-infrared spectroscopy (NIRS) results and neurologic outcome at 6months.ResultsIn total 120 patients were included in the analyses. There was a clear separation in PaCO2 (p
Subject: Carbon dioxide
Oxygen
Cardiac arrest
Intensive care
Neuron-specific enolase (NSE)
Hypoxic ischemic encephalopathy
Mechanical ventilation
MILD THERAPEUTIC HYPOTHERMIA
NEURON-SPECIFIC ENOLASE
TEMPERATURE MANAGEMENT
HYPEROXIA
ASSOCIATION
SURVIVORS
METAANALYSIS
MULTICENTER
SATURATION
MORTALITY
3126 Surgery, anesthesiology, intensive care, radiology
3121 General medicine, internal medicine and other clinical medicine
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