Cardiac arrest & resuscitation
The Effects of Targeted Mild Hypercapnia on Right Ventricular Function After Out-of-Hospital Cardiac Arrest: A Substudy of the Targeted Therapeutic Mild Hypercapnia After Resuscitated Cardiac Arrest Trial
Authors' conclusion
Among patients resuscitated from OHCA, targeting mild hypercapnia compared with normocapnia was not associated with worsened RV function, but rather with less RV dysfunction and failure. RV failure was associated with increased 6-month mortality.
Study context
- Population
- Patients resuscitated from out-of-hospital cardiac arrest (OHCA)Right heart catheterization (RHC) in 84
- Participants
- 111 patients
- Comparison
- Mild hypercapnia vs normocapnia for 24 hours
- Primary endpoint
- RV systolic dysfunction (2 of 3 of TAPSE, S', FAC below abnormal thresholds) and RV failure (RV systolic dysfunction with cardiac index < 2.0 L/min/m² and central venous pressure > 12 mm Hg)
- Follow-up
- During the intervention
Methodological detailssingle-centre, preplanned substudy
- Single-centre
- Preplanned substudy
Primary result
As reported in the abstract
RV systolic dysfunction
P < 0.001
Further findings
6-month mortality, right ventricular (RV) failure vs no RV failure
| HR (95% CI) | P value | ||
|---|---|---|---|
| RV failure | 2.89 (1.37–6.10) | P = 0.005 | |
| 0.10.31310Hazard ratio (log scale) |
Events
| Outcome | Hypercapnia | Normocapnia | P value |
|---|---|---|---|
| RV failure | 8 | 22 | P = 0.011 |
- RV failure: RV failure present in 30 patients
Tricuspid annular plane systolic excursion (TAPSE) at ICU admission
- Similarly reduced in both groups
Original publication
The Effects of Targeted Mild Hypercapnia on Right Ventricular Function After Out-of-Hospital Cardiac Arrest: A Substudy of the Targeted Therapeutic Mild Hypercapnia After Resuscitated Cardiac Arrest Trial. Chest. Published 24 November 2025. doi:10.
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