{"id":22565,"date":"2022-09-28T05:03:00","date_gmt":"2022-09-27T21:03:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=22565"},"modified":"2022-09-28T08:00:04","modified_gmt":"2022-09-28T00:00:04","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%bf%83%e8%b7%b3%e9%aa%a4%e5%81%9c%e5%90%8e%e6%98%8f%e8%bf%b7%e7%9a%84%e5%ad%98%e6%b4%bb%e8%80%85%e6%b0%a7%e5%90%88%e7%9b%ae%e6%a0%87","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=22565","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u5fc3\u8df3\u9aa4\u505c\u540e\u660f\u8ff7\u7684\u5b58\u6d3b\u8005\u6c27\u5408\u76ee\u6807"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

Oxygen Targets in Comatose Survivors of Cardiac Arrest<\/h1>\n\n\n\n

Henrik Schmidt, Jesper Kjaergaard, Christian Hassager,\u00a0et al<\/h3>\n\n\n\n

N Engl J Med August 27, 2022
DOI: 10.1056\/NEJMoa2208686<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h2>\n\n\n\n

The appropriate oxygenation target for mechanical ventilation in comatose survivors of out-of-hospital cardiac arrest is unknown.<\/p>\n\n\n\n

METHODS<\/h2>\n\n\n\n

In this randomized trial with a 2-by-2 factorial design, we randomly assigned comatose adults with out-of-hospital cardiac arrest in a 1:1 ratio to either a restrictive oxygen target of a partial pressure of arterial oxygen (Pao2<\/sub>) of 9 to 10 kPa (68 to 75 mm Hg) or a liberal oxygen target of a Pao2<\/sub> of 13 to 14 kPa (98 to 105 mm Hg); patients were also assigned to one of two blood-pressure targets (reported separately). The primary outcome was a composite of death from any cause or hospital discharge with severe disability or coma (Cerebral Performance Category [CPC] of 3 or 4; categories range from 1 to 5, with higher values indicating more severe disability), whichever occurred first within 90 days after randomization. Secondary outcomes were neuron-specific enolase levels at 48 hours, death from any cause, the score on the Montreal Cognitive Assessment (ranging from 0 to 30, with higher scores indicating better cognitive ability), the score on the modified Rankin scale (ranging from 0 to 6, with higher scores indicating greater disability), and the CPC at 90 days.<\/p>\n\n\n\n

RESULTS<\/h2>\n\n\n\n

A total of 789 patients underwent randomization. A primary-outcome event occurred in 126 of 394 patients (32.0%) in the restrictive-target group and in 134 of 395 patients (33.9%) in the liberal-target group (hazard ratio, 0.95; 95% confidence interval, 0.75 to 1.21; P=0.69). At 90 days, death had occurred in 113 patients (28.7%) in the restrictive-target group and in 123 (31.1%) in the liberal-target group. On the CPC, the median category was 1 in the two groups; on the modified Rankin scale, the median score was 2 in the restrictive-target group and 1 in the liberal-target group; and on the Montreal Cognitive Assessment, the median score was 27 in the two groups. At 48 hours, the median neuron-specific enolase level was 17 \u03bcg per liter in the restrictive-target group and 18 \u03bcg per liter in the liberal-target group. The incidence of adverse events was similar in the two groups.<\/p>\n\n\n\n

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CONCLUSIONS<\/h2>\n\n\n\n

Targeting of a restrictive or liberal oxygenation strategy in comatose patients after resuscitation for cardiac arrest resulted in a similar incidence of death or severe disability or coma. (Funded by the Novo Nordisk Foundation; BOX ClinicalTrials.gov number, NCT03141099. opens in new tab<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL ARTICLE Oxygen Targets in Comatose Survivors o […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22565"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=22565"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22565\/revisions"}],"predecessor-version":[{"id":22566,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22565\/revisions\/22566"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=22565"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=22565"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=22565"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}