Cardiac arrest & resuscitation

Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest

N Engl J MedPublished Randomised controlled trial

Primary result · Favorable neurologic outcomeResult — go to the resultRelative risk 0.98 95% CI 0.87–1.11

Authors' conclusion

In patients with coma who were resuscitated after out-of-hospital cardiac arrest, targeted mild hypercapnia did not lead to better neurologic outcomes at 6 months than targeted normocapnia.

Study context

Population
Comatose adults resuscitated after OHCA of presumed cardiac or unknown cause, admitted to the intensive care unit (ICU)63 ICUs in 17 countries
Participants
1,700 adults
Comparison
Targeted mild hypercapnia vs targeted normocapnia for 24 hours
  • Mild hypercapnian = 847
  • Normocapnian = 853reference
Primary endpoint
Favorable neurologic outcome (Glasgow Outcome Scale-Extended score ≥5)
Follow-up
6 months
Methodological detailsmulticentre
  • Multicentre

Primary result

Favorable neurologic outcome

Relative risk

0.98

95% CI 0.87–1.11

P = 0.76

Events by treatment group

Mild hypercapnia vs Normocapnia
RR 0.98 (95% CI 0.87–1.11); P = 0.76

As reported in the abstract

Secondary outcomes

OutcomeMild hypercapniaNormocapniaRR (95% CI)
Death within 6 months48.2%45.9%1.05 (0.94–1.16)
  • Death within 6 months: 393 of 816 vs 382 of 832

Safety

Adverse events

Incidence did not differ significantly between groups

Original publication

Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest. N Engl J Med. Published 15 June 2023. doi:10.1056/nejmoa2214552

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