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...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Huzaifa Ahmad Cheema (16328980) (author)
مؤلفون آخرون: Arman Shafiee (12870091) (author), Amirhossein Akhondi (16500870) (author), Niloofar Seighali (15246067) (author), Abia Shahid (16328984) (author), Mohammad Ebad Ur Rehman (16500872) (author), Talal Almas (9933829) (author), Sebastian Hadeed (13028241) (author), Abdulqadir J. Nashwan (16328993) (author), Soban Ahmad (16500875) (author)
منشور في: 2023
الموضوعات:
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author Huzaifa Ahmad Cheema (16328980)
author2 Arman Shafiee (12870091)
Amirhossein Akhondi (16500870)
Niloofar Seighali (15246067)
Abia Shahid (16328984)
Mohammad Ebad Ur Rehman (16500872)
Talal Almas (9933829)
Sebastian Hadeed (13028241)
Abdulqadir J. Nashwan (16328993)
Soban Ahmad (16500875)
author2_role author
author
author
author
author
author
author
author
author
author_facet Huzaifa Ahmad Cheema (16328980)
Arman Shafiee (12870091)
Amirhossein Akhondi (16500870)
Niloofar Seighali (15246067)
Abia Shahid (16328984)
Mohammad Ebad Ur Rehman (16500872)
Talal Almas (9933829)
Sebastian Hadeed (13028241)
Abdulqadir J. Nashwan (16328993)
Soban Ahmad (16500875)
author_role author
dc.creator.none.fl_str_mv Huzaifa Ahmad Cheema (16328980)
Arman Shafiee (12870091)
Amirhossein Akhondi (16500870)
Niloofar Seighali (15246067)
Abia Shahid (16328984)
Mohammad Ebad Ur Rehman (16500872)
Talal Almas (9933829)
Sebastian Hadeed (13028241)
Abdulqadir J. Nashwan (16328993)
Soban Ahmad (16500875)
dc.date.none.fl_str_mv 2023-08-01T00:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.ijcha.2023.101243
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Oxygen_targets_following_cardiac_arrest_A_meta-analysis_of_randomized_controlled_trials/23634534
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Cardiovascular medicine and haematology
Mathematical sciences
Statistics
Oxygen
Hyperoxia
Cardiac arrest
Meta-analysis
dc.title.none.fl_str_mv Oxygen targets following cardiac arrest: A meta-analysis of randomized controlled trials
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <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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network_acronym_str Manara2
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spelling Oxygen targets following cardiac arrest: A meta-analysis of randomized controlled trialsHuzaifa Ahmad Cheema (16328980)Arman Shafiee (12870091)Amirhossein Akhondi (16500870)Niloofar Seighali (15246067)Abia Shahid (16328984)Mohammad Ebad Ur Rehman (16500872)Talal Almas (9933829)Sebastian Hadeed (13028241)Abdulqadir J. Nashwan (16328993)Soban Ahmad (16500875)Biomedical and clinical sciencesCardiovascular medicine and haematologyMathematical sciencesStatisticsOxygenHyperoxiaCardiac arrestMeta-analysis<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>2023-08-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.ijcha.2023.101243https://figshare.com/articles/journal_contribution/Oxygen_targets_following_cardiac_arrest_A_meta-analysis_of_randomized_controlled_trials/23634534CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/236345342023-08-01T00:00:00Z
spellingShingle Oxygen targets following cardiac arrest: A meta-analysis of randomized controlled trials
Huzaifa Ahmad Cheema (16328980)
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Mathematical sciences
Statistics
Oxygen
Hyperoxia
Cardiac arrest
Meta-analysis
status_str publishedVersion
title Oxygen targets following cardiac arrest: A meta-analysis of randomized controlled trials
title_full Oxygen targets following cardiac arrest: A meta-analysis of randomized controlled trials
title_fullStr Oxygen targets following cardiac arrest: A meta-analysis of randomized controlled trials
title_full_unstemmed Oxygen targets following cardiac arrest: A meta-analysis of randomized controlled trials
title_short Oxygen targets following cardiac arrest: A meta-analysis of randomized controlled trials
title_sort Oxygen targets following cardiac arrest: A meta-analysis of randomized controlled trials
topic Biomedical and clinical sciences
Cardiovascular medicine and haematology
Mathematical sciences
Statistics
Oxygen
Hyperoxia
Cardiac arrest
Meta-analysis