Oxygen targets following cardiac arrest: A meta-analysis of randomized controlled trials
<h3>Introduction</h3> <p>The appropriate oxygen target post-resuscitation in out-of-hospital cardiac arrest (OHCA) patients is uncertain. We sought to compare lower versus higher oxygen targets in patients following OHCA.</p> <h3>Methods</h3> <p>We searched...
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| مؤلفون آخرون: | , , , , , , , , |
| منشور في: |
2023
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| الملخص: | <h3>Introduction</h3> <p>The appropriate oxygen target post-resuscitation in out-of-hospital cardiac arrest (OHCA) patients is uncertain. We sought to compare lower versus higher oxygen targets in patients following OHCA.</p> <h3>Methods</h3> <p>We searched MEDLINE, Embase, the Cochrane Library, and ClinicalTrials.gov until January 2023 to include all randomized<a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/randomized-controlled-trial" target="_blank"> </a>controlled trials (RCTs) that evaluated conservative vs. liberal oxygen therapy in OHCA patients. Our primary outcome was all-cause mortality at 90 days while our secondary outcomes were the level of neuron-specific enolase (NSE) at 48 h, ICU length of stay (LOS), and favorable neurological outcome (the proportion of patients with Cerebral Performance Category scores of 1–2 at end of follow-up). We used RevMan 5.4 to pool risk ratios (RRs) and mean differences (MDs).</p> <h3>Results</h3> <p>Nine trials with 1971 patients were included in our review. There was no significant difference between the conservative and liberal oxygen target groups regarding the rate of all-cause mortality (RR 0.95, 95% CI: 0.80 to 1.13; I2 = 55%). There were no significant differences between the two groups when assessing favorable neurological outcome (RR 1.01, 95% CI: 0.92 to 1.10; I2 = 4%), NSE at 48 h (MD 0.04, 95% CI: −0.67 to 0.76; I2 = 0%), and ICU length of stay (MD −2.86 days, 95% CI: −8.00 to 2.29 days; I2 = 0%).</p> <h3>Conclusions</h3> <p>Conservative oxygen therapy did not decrease mortality, improve neurologic recovery, or decrease ICU LOS as compared to a liberal oxygen regimen. Future large-scale RCTs comparing homogenous oxygen targets are needed to confirm these findings.</p> <h2>Other Information</h2> <p>Published in: IJC Heart & Vasculature<br> License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br> See article on publisher's website: <a href="https://doi.org/10.1016/j.ijcha.2023.101243" target="_blank">https://doi.org/10.1016/j.ijcha.2023.101243</a> </p> |
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