Oxygen targets and 6-month outcome after out of hospital cardiac arrest: a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial
Abstract Background Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO 2 ) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical v...
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| creator | Robba, Chiara Badenes, Rafael Battaglini, Denise Ball, Lorenzo Sanfilippo, Filippo Brunetti, Iole Jakobsen, Janus Christian Lilja, Gisela Friberg, Hans Wendel-Garcia, Pedro David Young, Paul Eastwood, Glenn Chew, Michelle Unden, Johan Thomas, Matthew Joannidis, Michael Nichol, Alistair Lundin, Andreas Hollenberg, Jacob Hammond, Naomi Saxena, Manoj Martin, Annborn Solar, Miroslav Taccone, Fabio Silvio Dankiewicz, Josef Nielsen, Niklas Grejs, Anders Morten Ebner, Florian Pelosi, Paolo Bělohlávek, Jan Callaway, Clifton Cariou, Alain Cronberg, Tobias Erlinge, David Hovdenes, Jan Kirkegaard, Hans Levin, Helena Morgan, Matt Nordberg, Per Oddo, Mauro Rylander, Christian Storm, Christian Ullén, Susann Wise, Matt Rowan, Kathy Harrison, David Mouncey, Paul Shankar-Hari, Manu Young, Duncan Lange, Theis Palmér, Karolina Karlsson, Ulla-Britt Heissler, Simon Bass, Frances Myburgh, John Taylor, Colman Bellino, Adele Abel-All, Marwa Finfer, Ben Koch, Carolyn Li, Yang O’connor, Anne Pilowsky, Julia Schneider, Tina Tippett, Anna Ady, Bridget Broadley, Tessa Brown, Amanda Melgaard, Liz Morgan, Mimi Singh, Vanessa Symons, Rebecca Becker, Kathrin Sante, Nathalie Saleova, Vendula Zerzanova, Silvie Sefir-Kribel, Samia Lübeck, Ute Carrara, Martina Fernando, Kathryn Mackle, Diane Navarra, Leanlove Riley, Judith Westerheim, Elin Flatebø, Marianne Ceric, Ameldina Haxhija, Zana Terling, Lovisa Bossmar, Lena Jergle, Liz Månsson, Helén Holm Maillard, Samia Abed Zagar, Andreja Vujicic Jodlauk, Christina Scrivens, Jennifer Ainscough, Kate Fahey, Ciara Bellomo, Rinaldo Peck, Leah Young, Helen |
| description | Abstract Background Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO 2 ) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO 2 with patients’ outcome. Methods Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO 2 300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. Results 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93–1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95–1.06). The time exposure, i.e., the area under the curve (PaO 2 -AUC), for hyperoxemia was significantly associated with mortality ( p = 0.003). Conclusions In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. Trial registration : clinicaltrials.gov NCT02908308 , Registered September 20, 2016. |
| doi_str_mv | 10.1186/s13054-022-04186-8 |
| format | Article |
| fullrecord | <record><control><sourceid>hal</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_03858024v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>oai_HAL_hal_03858024v1</sourcerecordid><originalsourceid>FETCH-hal_primary_oai_HAL_hal_03858024v13</originalsourceid><addsrcrecordid>eNqVjbtOxDAQRS0EEsvjB6imZAuDnYcJdKsVqxSgbVLQRUPibIwcO7KdFflJvokEFqip5s65MzqEXHF2w3kmbj2PWZpQFkWUJROg2RFZ8EQIKtj9y_GUY5HQLI3TU3Lm_Rtj_C4T8YJ8bN_HnTQQ0O1k8ICmBkE7a0ILdgiV7SRgE6SbN7ANtNb3KqCGCl2tsAJ0TvrwAAi9k7TXaIyswQ-vFA3q0Ss_v4VWHhxT2Y69nYDrFMJeOj_4v85Y1_2W3-btEKhtaP5jXh_Mqy8zXBfFc7SE4BTqC3LSoPby8jDPyXLzWKxz2qIue6c6dGNpUZX56qmcGYuzNGNRsufxf24_AT7TeBQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Oxygen targets and 6-month outcome after out of hospital cardiac arrest: a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial</title><source>PubMed (Medline)</source><source>SpringerOpen</source><source>DOAJ Directory of Open Access Journals</source><source>SpringerLink</source><source>Alma/SFX Local Collection</source><source>EZB Electronic Journals Library</source><creator>Robba, Chiara ; Badenes, Rafael ; Battaglini, Denise ; Ball, Lorenzo ; Sanfilippo, Filippo ; Brunetti, Iole ; Jakobsen, Janus Christian ; Lilja, Gisela ; Friberg, Hans ; Wendel-Garcia, Pedro David ; Young, Paul ; Eastwood, Glenn ; Chew, Michelle ; Unden, Johan ; Thomas, Matthew ; Joannidis, Michael ; Nichol, Alistair ; Lundin, Andreas ; Hollenberg, Jacob ; Hammond, Naomi ; Saxena, Manoj ; Martin, Annborn ; Solar, Miroslav ; Taccone, Fabio Silvio ; Dankiewicz, Josef ; Nielsen, Niklas ; Grejs, Anders Morten ; Ebner, Florian ; Pelosi, Paolo ; Bělohlávek, Jan ; Callaway, Clifton ; Cariou, Alain ; Cronberg, Tobias ; Erlinge, David ; Hovdenes, Jan ; Kirkegaard, Hans ; Levin, Helena ; Morgan, Matt ; Nordberg, Per ; Oddo, Mauro ; Rylander, Christian ; Storm, Christian ; Ullén, Susann ; Wise, Matt ; Rowan, Kathy ; Harrison, David ; Mouncey, Paul ; Shankar-Hari, Manu ; Young, Duncan ; Lange, Theis ; Palmér, Karolina ; Karlsson, Ulla-Britt ; Heissler, Simon ; Bass, Frances ; Myburgh, John ; Taylor, Colman ; Bellino, Adele ; Abel-All, Marwa ; Finfer, Ben ; Koch, Carolyn ; Li, Yang ; O’connor, Anne ; Pilowsky, Julia ; Schneider, Tina ; Tippett, Anna ; Ady, Bridget ; Broadley, Tessa ; Brown, Amanda ; Melgaard, Liz ; Morgan, Mimi ; Singh, Vanessa ; Symons, Rebecca ; Becker, Kathrin ; Sante, Nathalie ; Saleova, Vendula ; Zerzanova, Silvie ; Sefir-Kribel, Samia ; Lübeck, Ute ; Carrara, Martina ; Fernando, Kathryn ; Mackle, Diane ; Navarra, Leanlove ; Riley, Judith ; Westerheim, Elin ; Flatebø, Marianne ; Ceric, Ameldina ; Haxhija, Zana ; Terling, Lovisa ; Bossmar, Lena ; Jergle, Liz ; Månsson, Helén Holm ; Maillard, Samia Abed ; Zagar, Andreja Vujicic ; Jodlauk, Christina ; Scrivens, Jennifer ; Ainscough, Kate ; Fahey, Ciara ; Bellomo, Rinaldo ; Peck, Leah ; Young, Helen</creator><creatorcontrib>Robba, Chiara ; Badenes, Rafael ; Battaglini, Denise ; Ball, Lorenzo ; Sanfilippo, Filippo ; Brunetti, Iole ; Jakobsen, Janus Christian ; Lilja, Gisela ; Friberg, Hans ; Wendel-Garcia, Pedro David ; Young, Paul ; Eastwood, Glenn ; Chew, Michelle ; Unden, Johan ; Thomas, Matthew ; Joannidis, Michael ; Nichol, Alistair ; Lundin, Andreas ; Hollenberg, Jacob ; Hammond, Naomi ; Saxena, Manoj ; Martin, Annborn ; Solar, Miroslav ; Taccone, Fabio Silvio ; Dankiewicz, Josef ; Nielsen, Niklas ; Grejs, Anders Morten ; Ebner, Florian ; Pelosi, Paolo ; Bělohlávek, Jan ; Callaway, Clifton ; Cariou, Alain ; Cronberg, Tobias ; Erlinge, David ; Hovdenes, Jan ; Kirkegaard, Hans ; Levin, Helena ; Morgan, Matt ; Nordberg, Per ; Oddo, Mauro ; Rylander, Christian ; Storm, Christian ; Ullén, Susann ; Wise, Matt ; Rowan, Kathy ; Harrison, David ; Mouncey, Paul ; Shankar-Hari, Manu ; Young, Duncan ; Lange, Theis ; Palmér, Karolina ; Karlsson, Ulla-Britt ; Heissler, Simon ; Bass, Frances ; Myburgh, John ; Taylor, Colman ; Bellino, Adele ; Abel-All, Marwa ; Finfer, Ben ; Koch, Carolyn ; Li, Yang ; O’connor, Anne ; Pilowsky, Julia ; Schneider, Tina ; Tippett, Anna ; Ady, Bridget ; Broadley, Tessa ; Brown, Amanda ; Melgaard, Liz ; Morgan, Mimi ; Singh, Vanessa ; Symons, Rebecca ; Becker, Kathrin ; Sante, Nathalie ; Saleova, Vendula ; Zerzanova, Silvie ; Sefir-Kribel, Samia ; Lübeck, Ute ; Carrara, Martina ; Fernando, Kathryn ; Mackle, Diane ; Navarra, Leanlove ; Riley, Judith ; Westerheim, Elin ; Flatebø, Marianne ; Ceric, Ameldina ; Haxhija, Zana ; Terling, Lovisa ; Bossmar, Lena ; Jergle, Liz ; Månsson, Helén Holm ; Maillard, Samia Abed ; Zagar, Andreja Vujicic ; Jodlauk, Christina ; Scrivens, Jennifer ; Ainscough, Kate ; Fahey, Ciara ; Bellomo, Rinaldo ; Peck, Leah ; Young, Helen</creatorcontrib><description>Abstract Background Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO 2 ) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO 2 with patients’ outcome. Methods Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO 2 < 60 mmHg and severe hyperoxemia as PaO 2 > 300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. Results 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93–1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95–1.06). The time exposure, i.e., the area under the curve (PaO 2 -AUC), for hyperoxemia was significantly associated with mortality ( p = 0.003). Conclusions In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. Trial registration : clinicaltrials.gov NCT02908308 , Registered September 20, 2016.</description><identifier>ISSN: 1364-8535</identifier><identifier>EISSN: 1466-609X</identifier><identifier>DOI: 10.1186/s13054-022-04186-8</identifier><language>eng</language><publisher>BioMed Central</publisher><subject>Cardiology and cardiovascular system ; Emerging diseases ; Human health and pathology ; Infectious diseases ; Life Sciences ; Pulmonology and respiratory tract ; Toxicology</subject><ispartof>Critical care (London, England), 2022-12, Vol.26 (1)</ispartof><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0003-3706-078X ; 0000-0003-1628-3845 ; 0000-0002-2522-2764 ; 0000-0003-1628-3845</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,860,881,27901,27902</link.rule.ids><backlink>$$Uhttps://hal.science/hal-03858024$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Robba, Chiara</creatorcontrib><creatorcontrib>Badenes, Rafael</creatorcontrib><creatorcontrib>Battaglini, Denise</creatorcontrib><creatorcontrib>Ball, Lorenzo</creatorcontrib><creatorcontrib>Sanfilippo, Filippo</creatorcontrib><creatorcontrib>Brunetti, Iole</creatorcontrib><creatorcontrib>Jakobsen, Janus Christian</creatorcontrib><creatorcontrib>Lilja, Gisela</creatorcontrib><creatorcontrib>Friberg, Hans</creatorcontrib><creatorcontrib>Wendel-Garcia, Pedro David</creatorcontrib><creatorcontrib>Young, Paul</creatorcontrib><creatorcontrib>Eastwood, Glenn</creatorcontrib><creatorcontrib>Chew, Michelle</creatorcontrib><creatorcontrib>Unden, Johan</creatorcontrib><creatorcontrib>Thomas, Matthew</creatorcontrib><creatorcontrib>Joannidis, Michael</creatorcontrib><creatorcontrib>Nichol, Alistair</creatorcontrib><creatorcontrib>Lundin, Andreas</creatorcontrib><creatorcontrib>Hollenberg, Jacob</creatorcontrib><creatorcontrib>Hammond, Naomi</creatorcontrib><creatorcontrib>Saxena, Manoj</creatorcontrib><creatorcontrib>Martin, Annborn</creatorcontrib><creatorcontrib>Solar, Miroslav</creatorcontrib><creatorcontrib>Taccone, Fabio Silvio</creatorcontrib><creatorcontrib>Dankiewicz, Josef</creatorcontrib><creatorcontrib>Nielsen, Niklas</creatorcontrib><creatorcontrib>Grejs, Anders Morten</creatorcontrib><creatorcontrib>Ebner, Florian</creatorcontrib><creatorcontrib>Pelosi, Paolo</creatorcontrib><creatorcontrib>Bělohlávek, Jan</creatorcontrib><creatorcontrib>Callaway, Clifton</creatorcontrib><creatorcontrib>Cariou, Alain</creatorcontrib><creatorcontrib>Cronberg, Tobias</creatorcontrib><creatorcontrib>Erlinge, David</creatorcontrib><creatorcontrib>Hovdenes, Jan</creatorcontrib><creatorcontrib>Kirkegaard, Hans</creatorcontrib><creatorcontrib>Levin, Helena</creatorcontrib><creatorcontrib>Morgan, Matt</creatorcontrib><creatorcontrib>Nordberg, Per</creatorcontrib><creatorcontrib>Oddo, Mauro</creatorcontrib><creatorcontrib>Rylander, Christian</creatorcontrib><creatorcontrib>Storm, Christian</creatorcontrib><creatorcontrib>Ullén, Susann</creatorcontrib><creatorcontrib>Wise, Matt</creatorcontrib><creatorcontrib>Rowan, Kathy</creatorcontrib><creatorcontrib>Harrison, David</creatorcontrib><creatorcontrib>Mouncey, Paul</creatorcontrib><creatorcontrib>Shankar-Hari, Manu</creatorcontrib><creatorcontrib>Young, Duncan</creatorcontrib><creatorcontrib>Lange, Theis</creatorcontrib><creatorcontrib>Palmér, Karolina</creatorcontrib><creatorcontrib>Karlsson, Ulla-Britt</creatorcontrib><creatorcontrib>Heissler, Simon</creatorcontrib><creatorcontrib>Bass, Frances</creatorcontrib><creatorcontrib>Myburgh, John</creatorcontrib><creatorcontrib>Taylor, Colman</creatorcontrib><creatorcontrib>Bellino, Adele</creatorcontrib><creatorcontrib>Abel-All, Marwa</creatorcontrib><creatorcontrib>Finfer, Ben</creatorcontrib><creatorcontrib>Koch, Carolyn</creatorcontrib><creatorcontrib>Li, Yang</creatorcontrib><creatorcontrib>O’connor, Anne</creatorcontrib><creatorcontrib>Pilowsky, Julia</creatorcontrib><creatorcontrib>Schneider, Tina</creatorcontrib><creatorcontrib>Tippett, Anna</creatorcontrib><creatorcontrib>Ady, Bridget</creatorcontrib><creatorcontrib>Broadley, Tessa</creatorcontrib><creatorcontrib>Brown, Amanda</creatorcontrib><creatorcontrib>Melgaard, Liz</creatorcontrib><creatorcontrib>Morgan, Mimi</creatorcontrib><creatorcontrib>Singh, Vanessa</creatorcontrib><creatorcontrib>Symons, Rebecca</creatorcontrib><creatorcontrib>Becker, Kathrin</creatorcontrib><creatorcontrib>Sante, Nathalie</creatorcontrib><creatorcontrib>Saleova, Vendula</creatorcontrib><creatorcontrib>Zerzanova, Silvie</creatorcontrib><creatorcontrib>Sefir-Kribel, Samia</creatorcontrib><creatorcontrib>Lübeck, Ute</creatorcontrib><creatorcontrib>Carrara, Martina</creatorcontrib><creatorcontrib>Fernando, Kathryn</creatorcontrib><creatorcontrib>Mackle, Diane</creatorcontrib><creatorcontrib>Navarra, Leanlove</creatorcontrib><creatorcontrib>Riley, Judith</creatorcontrib><creatorcontrib>Westerheim, Elin</creatorcontrib><creatorcontrib>Flatebø, Marianne</creatorcontrib><creatorcontrib>Ceric, Ameldina</creatorcontrib><creatorcontrib>Haxhija, Zana</creatorcontrib><creatorcontrib>Terling, Lovisa</creatorcontrib><creatorcontrib>Bossmar, Lena</creatorcontrib><creatorcontrib>Jergle, Liz</creatorcontrib><creatorcontrib>Månsson, Helén Holm</creatorcontrib><creatorcontrib>Maillard, Samia Abed</creatorcontrib><creatorcontrib>Zagar, Andreja Vujicic</creatorcontrib><creatorcontrib>Jodlauk, Christina</creatorcontrib><creatorcontrib>Scrivens, Jennifer</creatorcontrib><creatorcontrib>Ainscough, Kate</creatorcontrib><creatorcontrib>Fahey, Ciara</creatorcontrib><creatorcontrib>Bellomo, Rinaldo</creatorcontrib><creatorcontrib>Peck, Leah</creatorcontrib><creatorcontrib>Young, Helen</creatorcontrib><title>Oxygen targets and 6-month outcome after out of hospital cardiac arrest: a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial</title><title>Critical care (London, England)</title><description>Abstract Background Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO 2 ) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO 2 with patients’ outcome. Methods Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO 2 < 60 mmHg and severe hyperoxemia as PaO 2 > 300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. Results 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93–1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95–1.06). The time exposure, i.e., the area under the curve (PaO 2 -AUC), for hyperoxemia was significantly associated with mortality ( p = 0.003). Conclusions In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. Trial registration : clinicaltrials.gov NCT02908308 , Registered September 20, 2016.</description><subject>Cardiology and cardiovascular system</subject><subject>Emerging diseases</subject><subject>Human health and pathology</subject><subject>Infectious diseases</subject><subject>Life Sciences</subject><subject>Pulmonology and respiratory tract</subject><subject>Toxicology</subject><issn>1364-8535</issn><issn>1466-609X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNqVjbtOxDAQRS0EEsvjB6imZAuDnYcJdKsVqxSgbVLQRUPibIwcO7KdFflJvokEFqip5s65MzqEXHF2w3kmbj2PWZpQFkWUJROg2RFZ8EQIKtj9y_GUY5HQLI3TU3Lm_Rtj_C4T8YJ8bN_HnTQQ0O1k8ICmBkE7a0ILdgiV7SRgE6SbN7ANtNb3KqCGCl2tsAJ0TvrwAAi9k7TXaIyswQ-vFA3q0Ss_v4VWHhxT2Y69nYDrFMJeOj_4v85Y1_2W3-btEKhtaP5jXh_Mqy8zXBfFc7SE4BTqC3LSoPby8jDPyXLzWKxz2qIue6c6dGNpUZX56qmcGYuzNGNRsufxf24_AT7TeBQ</recordid><startdate>202212</startdate><enddate>202212</enddate><creator>Robba, Chiara</creator><creator>Badenes, Rafael</creator><creator>Battaglini, Denise</creator><creator>Ball, Lorenzo</creator><creator>Sanfilippo, Filippo</creator><creator>Brunetti, Iole</creator><creator>Jakobsen, Janus Christian</creator><creator>Lilja, Gisela</creator><creator>Friberg, Hans</creator><creator>Wendel-Garcia, Pedro David</creator><creator>Young, Paul</creator><creator>Eastwood, Glenn</creator><creator>Chew, Michelle</creator><creator>Unden, Johan</creator><creator>Thomas, Matthew</creator><creator>Joannidis, Michael</creator><creator>Nichol, Alistair</creator><creator>Lundin, Andreas</creator><creator>Hollenberg, Jacob</creator><creator>Hammond, Naomi</creator><creator>Saxena, Manoj</creator><creator>Martin, Annborn</creator><creator>Solar, Miroslav</creator><creator>Taccone, Fabio Silvio</creator><creator>Dankiewicz, Josef</creator><creator>Nielsen, Niklas</creator><creator>Grejs, Anders Morten</creator><creator>Ebner, Florian</creator><creator>Pelosi, 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Lena</creator><creator>Jergle, Liz</creator><creator>Månsson, Helén Holm</creator><creator>Maillard, Samia Abed</creator><creator>Zagar, Andreja Vujicic</creator><creator>Jodlauk, Christina</creator><creator>Scrivens, Jennifer</creator><creator>Ainscough, Kate</creator><creator>Fahey, Ciara</creator><creator>Bellomo, Rinaldo</creator><creator>Peck, Leah</creator><creator>Young, Helen</creator><general>BioMed Central</general><scope>1XC</scope><orcidid>https://orcid.org/0000-0003-3706-078X</orcidid><orcidid>https://orcid.org/0000-0003-1628-3845</orcidid><orcidid>https://orcid.org/0000-0002-2522-2764</orcidid><orcidid>https://orcid.org/0000-0003-1628-3845</orcidid></search><sort><creationdate>202212</creationdate><title>Oxygen targets and 6-month outcome after out of hospital cardiac arrest: a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial</title><author>Robba, Chiara ; Badenes, Rafael ; Battaglini, Denise ; Ball, Lorenzo ; Sanfilippo, Filippo ; Brunetti, Iole ; Jakobsen, Janus Christian ; Lilja, Gisela ; Friberg, Hans ; Wendel-Garcia, Pedro David ; Young, Paul ; Eastwood, Glenn ; Chew, Michelle ; Unden, Johan ; Thomas, Matthew ; Joannidis, Michael ; Nichol, Alistair ; Lundin, Andreas ; Hollenberg, Jacob ; Hammond, Naomi ; Saxena, Manoj ; Martin, Annborn ; Solar, Miroslav ; Taccone, Fabio Silvio ; Dankiewicz, Josef ; Nielsen, Niklas ; Grejs, Anders Morten ; Ebner, Florian ; Pelosi, Paolo ; Bělohlávek, Jan ; Callaway, Clifton ; Cariou, Alain ; Cronberg, Tobias ; Erlinge, David ; Hovdenes, Jan ; Kirkegaard, Hans ; Levin, Helena ; Morgan, Matt ; Nordberg, Per ; Oddo, Mauro ; Rylander, Christian ; Storm, Christian ; Ullén, Susann ; Wise, Matt ; Rowan, Kathy ; Harrison, David ; Mouncey, Paul ; Shankar-Hari, Manu ; Young, Duncan ; Lange, Theis ; Palmér, Karolina ; Karlsson, Ulla-Britt ; Heissler, Simon ; Bass, Frances ; Myburgh, John ; Taylor, Colman ; Bellino, Adele ; Abel-All, Marwa ; Finfer, Ben ; Koch, Carolyn ; Li, Yang ; O’connor, Anne ; Pilowsky, Julia ; Schneider, Tina ; Tippett, Anna ; Ady, Bridget ; Broadley, Tessa ; Brown, Amanda ; Melgaard, Liz ; Morgan, Mimi ; Singh, Vanessa ; Symons, Rebecca ; Becker, Kathrin ; Sante, Nathalie ; Saleova, Vendula ; Zerzanova, Silvie ; Sefir-Kribel, Samia ; Lübeck, Ute ; Carrara, Martina ; Fernando, Kathryn ; Mackle, Diane ; Navarra, Leanlove ; Riley, Judith ; Westerheim, Elin ; Flatebø, Marianne ; Ceric, Ameldina ; Haxhija, Zana ; Terling, Lovisa ; Bossmar, Lena ; Jergle, Liz ; Månsson, Helén Holm ; Maillard, Samia Abed ; Zagar, Andreja Vujicic ; Jodlauk, Christina ; Scrivens, Jennifer ; Ainscough, Kate ; Fahey, Ciara ; Bellomo, Rinaldo ; Peck, Leah ; Young, Helen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-hal_primary_oai_HAL_hal_03858024v13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cardiology and cardiovascular system</topic><topic>Emerging diseases</topic><topic>Human health and pathology</topic><topic>Infectious diseases</topic><topic>Life Sciences</topic><topic>Pulmonology and respiratory tract</topic><topic>Toxicology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Robba, Chiara</creatorcontrib><creatorcontrib>Badenes, Rafael</creatorcontrib><creatorcontrib>Battaglini, Denise</creatorcontrib><creatorcontrib>Ball, Lorenzo</creatorcontrib><creatorcontrib>Sanfilippo, Filippo</creatorcontrib><creatorcontrib>Brunetti, Iole</creatorcontrib><creatorcontrib>Jakobsen, Janus Christian</creatorcontrib><creatorcontrib>Lilja, Gisela</creatorcontrib><creatorcontrib>Friberg, Hans</creatorcontrib><creatorcontrib>Wendel-Garcia, Pedro David</creatorcontrib><creatorcontrib>Young, Paul</creatorcontrib><creatorcontrib>Eastwood, Glenn</creatorcontrib><creatorcontrib>Chew, Michelle</creatorcontrib><creatorcontrib>Unden, Johan</creatorcontrib><creatorcontrib>Thomas, Matthew</creatorcontrib><creatorcontrib>Joannidis, Michael</creatorcontrib><creatorcontrib>Nichol, Alistair</creatorcontrib><creatorcontrib>Lundin, Andreas</creatorcontrib><creatorcontrib>Hollenberg, Jacob</creatorcontrib><creatorcontrib>Hammond, Naomi</creatorcontrib><creatorcontrib>Saxena, Manoj</creatorcontrib><creatorcontrib>Martin, Annborn</creatorcontrib><creatorcontrib>Solar, Miroslav</creatorcontrib><creatorcontrib>Taccone, Fabio Silvio</creatorcontrib><creatorcontrib>Dankiewicz, Josef</creatorcontrib><creatorcontrib>Nielsen, Niklas</creatorcontrib><creatorcontrib>Grejs, Anders Morten</creatorcontrib><creatorcontrib>Ebner, Florian</creatorcontrib><creatorcontrib>Pelosi, Paolo</creatorcontrib><creatorcontrib>Bělohlávek, Jan</creatorcontrib><creatorcontrib>Callaway, Clifton</creatorcontrib><creatorcontrib>Cariou, Alain</creatorcontrib><creatorcontrib>Cronberg, Tobias</creatorcontrib><creatorcontrib>Erlinge, David</creatorcontrib><creatorcontrib>Hovdenes, Jan</creatorcontrib><creatorcontrib>Kirkegaard, Hans</creatorcontrib><creatorcontrib>Levin, Helena</creatorcontrib><creatorcontrib>Morgan, Matt</creatorcontrib><creatorcontrib>Nordberg, Per</creatorcontrib><creatorcontrib>Oddo, Mauro</creatorcontrib><creatorcontrib>Rylander, Christian</creatorcontrib><creatorcontrib>Storm, Christian</creatorcontrib><creatorcontrib>Ullén, Susann</creatorcontrib><creatorcontrib>Wise, Matt</creatorcontrib><creatorcontrib>Rowan, Kathy</creatorcontrib><creatorcontrib>Harrison, David</creatorcontrib><creatorcontrib>Mouncey, Paul</creatorcontrib><creatorcontrib>Shankar-Hari, Manu</creatorcontrib><creatorcontrib>Young, Duncan</creatorcontrib><creatorcontrib>Lange, Theis</creatorcontrib><creatorcontrib>Palmér, Karolina</creatorcontrib><creatorcontrib>Karlsson, Ulla-Britt</creatorcontrib><creatorcontrib>Heissler, Simon</creatorcontrib><creatorcontrib>Bass, Frances</creatorcontrib><creatorcontrib>Myburgh, John</creatorcontrib><creatorcontrib>Taylor, Colman</creatorcontrib><creatorcontrib>Bellino, Adele</creatorcontrib><creatorcontrib>Abel-All, Marwa</creatorcontrib><creatorcontrib>Finfer, Ben</creatorcontrib><creatorcontrib>Koch, Carolyn</creatorcontrib><creatorcontrib>Li, Yang</creatorcontrib><creatorcontrib>O’connor, Anne</creatorcontrib><creatorcontrib>Pilowsky, Julia</creatorcontrib><creatorcontrib>Schneider, Tina</creatorcontrib><creatorcontrib>Tippett, Anna</creatorcontrib><creatorcontrib>Ady, Bridget</creatorcontrib><creatorcontrib>Broadley, Tessa</creatorcontrib><creatorcontrib>Brown, Amanda</creatorcontrib><creatorcontrib>Melgaard, Liz</creatorcontrib><creatorcontrib>Morgan, Mimi</creatorcontrib><creatorcontrib>Singh, Vanessa</creatorcontrib><creatorcontrib>Symons, Rebecca</creatorcontrib><creatorcontrib>Becker, Kathrin</creatorcontrib><creatorcontrib>Sante, Nathalie</creatorcontrib><creatorcontrib>Saleova, Vendula</creatorcontrib><creatorcontrib>Zerzanova, Silvie</creatorcontrib><creatorcontrib>Sefir-Kribel, Samia</creatorcontrib><creatorcontrib>Lübeck, Ute</creatorcontrib><creatorcontrib>Carrara, Martina</creatorcontrib><creatorcontrib>Fernando, Kathryn</creatorcontrib><creatorcontrib>Mackle, Diane</creatorcontrib><creatorcontrib>Navarra, Leanlove</creatorcontrib><creatorcontrib>Riley, Judith</creatorcontrib><creatorcontrib>Westerheim, Elin</creatorcontrib><creatorcontrib>Flatebø, Marianne</creatorcontrib><creatorcontrib>Ceric, Ameldina</creatorcontrib><creatorcontrib>Haxhija, Zana</creatorcontrib><creatorcontrib>Terling, Lovisa</creatorcontrib><creatorcontrib>Bossmar, Lena</creatorcontrib><creatorcontrib>Jergle, Liz</creatorcontrib><creatorcontrib>Månsson, Helén Holm</creatorcontrib><creatorcontrib>Maillard, Samia Abed</creatorcontrib><creatorcontrib>Zagar, Andreja Vujicic</creatorcontrib><creatorcontrib>Jodlauk, Christina</creatorcontrib><creatorcontrib>Scrivens, Jennifer</creatorcontrib><creatorcontrib>Ainscough, Kate</creatorcontrib><creatorcontrib>Fahey, Ciara</creatorcontrib><creatorcontrib>Bellomo, Rinaldo</creatorcontrib><creatorcontrib>Peck, Leah</creatorcontrib><creatorcontrib>Young, Helen</creatorcontrib><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Critical care (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Robba, Chiara</au><au>Badenes, Rafael</au><au>Battaglini, Denise</au><au>Ball, Lorenzo</au><au>Sanfilippo, Filippo</au><au>Brunetti, Iole</au><au>Jakobsen, Janus Christian</au><au>Lilja, Gisela</au><au>Friberg, Hans</au><au>Wendel-Garcia, Pedro David</au><au>Young, Paul</au><au>Eastwood, Glenn</au><au>Chew, Michelle</au><au>Unden, Johan</au><au>Thomas, Matthew</au><au>Joannidis, Michael</au><au>Nichol, Alistair</au><au>Lundin, Andreas</au><au>Hollenberg, Jacob</au><au>Hammond, Naomi</au><au>Saxena, Manoj</au><au>Martin, Annborn</au><au>Solar, Miroslav</au><au>Taccone, Fabio Silvio</au><au>Dankiewicz, Josef</au><au>Nielsen, Niklas</au><au>Grejs, Anders Morten</au><au>Ebner, Florian</au><au>Pelosi, Paolo</au><au>Bělohlávek, Jan</au><au>Callaway, Clifton</au><au>Cariou, Alain</au><au>Cronberg, Tobias</au><au>Erlinge, David</au><au>Hovdenes, Jan</au><au>Kirkegaard, Hans</au><au>Levin, Helena</au><au>Morgan, Matt</au><au>Nordberg, Per</au><au>Oddo, Mauro</au><au>Rylander, Christian</au><au>Storm, Christian</au><au>Ullén, Susann</au><au>Wise, Matt</au><au>Rowan, Kathy</au><au>Harrison, David</au><au>Mouncey, Paul</au><au>Shankar-Hari, Manu</au><au>Young, Duncan</au><au>Lange, Theis</au><au>Palmér, Karolina</au><au>Karlsson, Ulla-Britt</au><au>Heissler, Simon</au><au>Bass, Frances</au><au>Myburgh, John</au><au>Taylor, Colman</au><au>Bellino, Adele</au><au>Abel-All, Marwa</au><au>Finfer, Ben</au><au>Koch, Carolyn</au><au>Li, Yang</au><au>O’connor, Anne</au><au>Pilowsky, Julia</au><au>Schneider, Tina</au><au>Tippett, Anna</au><au>Ady, Bridget</au><au>Broadley, Tessa</au><au>Brown, Amanda</au><au>Melgaard, Liz</au><au>Morgan, Mimi</au><au>Singh, Vanessa</au><au>Symons, Rebecca</au><au>Becker, Kathrin</au><au>Sante, Nathalie</au><au>Saleova, Vendula</au><au>Zerzanova, Silvie</au><au>Sefir-Kribel, Samia</au><au>Lübeck, Ute</au><au>Carrara, Martina</au><au>Fernando, Kathryn</au><au>Mackle, Diane</au><au>Navarra, Leanlove</au><au>Riley, Judith</au><au>Westerheim, Elin</au><au>Flatebø, Marianne</au><au>Ceric, Ameldina</au><au>Haxhija, Zana</au><au>Terling, Lovisa</au><au>Bossmar, Lena</au><au>Jergle, Liz</au><au>Månsson, Helén Holm</au><au>Maillard, Samia Abed</au><au>Zagar, Andreja Vujicic</au><au>Jodlauk, Christina</au><au>Scrivens, Jennifer</au><au>Ainscough, Kate</au><au>Fahey, Ciara</au><au>Bellomo, Rinaldo</au><au>Peck, Leah</au><au>Young, Helen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oxygen targets and 6-month outcome after out of hospital cardiac arrest: a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial</atitle><jtitle>Critical care (London, England)</jtitle><date>2022-12</date><risdate>2022</risdate><volume>26</volume><issue>1</issue><issn>1364-8535</issn><eissn>1466-609X</eissn><abstract>Abstract Background Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO 2 ) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO 2 with patients’ outcome. Methods Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO 2 < 60 mmHg and severe hyperoxemia as PaO 2 > 300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. Results 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93–1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95–1.06). The time exposure, i.e., the area under the curve (PaO 2 -AUC), for hyperoxemia was significantly associated with mortality ( p = 0.003). Conclusions In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. Trial registration : clinicaltrials.gov NCT02908308 , Registered September 20, 2016.</abstract><pub>BioMed Central</pub><doi>10.1186/s13054-022-04186-8</doi><orcidid>https://orcid.org/0000-0003-3706-078X</orcidid><orcidid>https://orcid.org/0000-0003-1628-3845</orcidid><orcidid>https://orcid.org/0000-0002-2522-2764</orcidid><orcidid>https://orcid.org/0000-0003-1628-3845</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1364-8535 |
| ispartof | Critical care (London, England), 2022-12, Vol.26 (1) |
| issn | 1364-8535 1466-609X |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_03858024v1 |
| source | PubMed (Medline); SpringerOpen; DOAJ Directory of Open Access Journals; SpringerLink; Alma/SFX Local Collection; EZB Electronic Journals Library |
| subjects | Cardiology and cardiovascular system Emerging diseases Human health and pathology Infectious diseases Life Sciences Pulmonology and respiratory tract Toxicology |
| title | Oxygen targets and 6-month outcome after out of hospital cardiac arrest: a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial |
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