Manara - Qatar Research Repository
Browse
1/1
2 files

Oxygen targets following cardiac arrest: A meta-analysis of randomized controlled trials

Version 2 2023-10-19, 06:49
Version 1 2023-07-06, 13:22
journal contribution
revised on 2023-10-19, 06:48 and posted on 2023-10-19, 06:49 authored by Huzaifa Ahmad Cheema, Arman Shafiee, Amirhossein Akhondi, Niloofar Seighali, Abia Shahid, Mohammad Ebad Ur Rehman, Talal Almas, Sebastian Hadeed, Abdulqadir J. Nashwan, Soban Ahmad

Introduction

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.

Methods

We searched MEDLINE, Embase, the Cochrane Library, and ClinicalTrials.gov until January 2023 to include all randomized 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).

Results

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%).

Conclusions

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.

Other Information

Published in: IJC Heart & Vasculature
License: https://creativecommons.org/licenses/by/4.0/
See article on publisher's website: https://doi.org/10.1016/j.ijcha.2023.101243 

Funding

Open Access funding provided by the Qatar National Library

History

Language

  • English

Publisher

Elsevier

Publication Year

  • 2023

License statement

This Item is licensed under the Creative Commons Attribution 4.0 International License

Institution affiliated with

  • Hamad Medical Corporation

Usage metrics

    Hamad Medical Corporation

    Licence

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC