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Blood-Pressure Targets in Comatose Survivors of Cardiac Arrest

By Currents Editor posted 24 days ago

  

New England Journal of Medicine (10/20/22) DOI: 10.1056/NEJMoa2208687
Kjaergaard, Jesper; Møller, Jacob E.; Schmidt, Henrik; et al.
https://www.nejm.org/doi/full/10.1056/NEJMoa2208687 

For patients who had been resuscitated from cardiac arrest, targeting a mean arterial blood pressure of 77 mm Hg or 63 mm Hg did not result in significant differences in terms of the percentages of patients who died or had severe disability or coma, new research indicates. The double-blind trial randomly assigned 393 comatose adults who had been resuscitated after an out-of-hospital cardiac arrest to a mean arterial blood-pressure target of 77 mm Hg and 396 patients to a mean arterial blood-pressure target of 63 mm Hg. Patients were also assigned to one of two oxygen targets. A primary-outcome event — a composite of death from any cause or hospital discharge with a Cerebral Performance Category (CPC) of 3 or 4 within 90 days — was reported in 34% (133) of the patients in the high-target group and 32% (127) of those in the low-target group. The mortality rate at 90 days was 31% (122) in the high-target group and 29% (114) in the low-target group. At three months, both groups had a median CPC of 1 and median modified Rankin scores of 1, while the median Montreal Cognitive Assessment scores were 27 and 26, respectively. The two groups also had similar median neuron-specific enolase levels at 48 hours, with no significant differences in the percentages of patients with adverse events.

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New England Journal of Medicine (10/20/22) DOI: 10.1056/NEJMoa2208687 Kjaergaard, Jesper; Møller, Jacob E.; Schmidt, Henrik; et al. https://www.nejm.org/doi/full/10.1056/NEJMoa2208687 For patients who had been resuscitated from cardiac arrest, targeting a mean arterial blood pressure of 77 mm Hg ...
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