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dc.contributor.authorAMELOOT, Koen-
dc.contributor.authorDE DEYNE, Cathy-
dc.contributor.authorEERTMANS, Ward-
dc.contributor.authorFerdinande, Bert-
dc.contributor.authorDUPONT, Matthias-
dc.contributor.authorPalmers, Pieter-Jan-
dc.contributor.authorPetit, Tibaut-
dc.contributor.authorNuyens, Philippe-
dc.contributor.authorMAEREMANS, Joren-
dc.contributor.authorVundelinckx, Joris-
dc.contributor.authorVanhaverbeke, Maarten-
dc.contributor.authorBelmans, Ann-
dc.contributor.authorPeeters, Ronald-
dc.contributor.authorDemaerel, Philippe-
dc.contributor.authorLemmens, Robin-
dc.contributor.authorDENS, Jo-
dc.contributor.authorJanssens, Stefan-
dc.identifier.citationEUROPEAN HEART JOURNAL, 40(22), p. 1804-1814-
dc.description.abstractAims During the first 6-12 h of intensive care unit (ICU) stay, post-cardiac arrest (CA) patients treated with a mean arterial pressure (MAP) 65 mmHg target experience a drop of the cerebral oxygenation that may cause additional cerebral damage. Therefore, we investigated whether an early goal directed haemodynamic optimization strategy (EGDHO) (MAP 85-100 mmHg, SVO2 65-75%) is safe and could improve cerebral oxygenation, reduce anoxic brain damage, and improve outcome when compared with a MAP 65 mmHg strategy. Methods and results A total of 112 out-of-hospital CA patients were randomly assigned to EGDHO or MAP 65 mmHg strategies during the first 36 h of ICU stay. The primary outcome was the extent of anoxic brain damage as quantified by the percentage of voxels below an apparent diffusion coefficient (ADC) score of 650.10(-6) mm(2)/s on diffusion weighted magnetic resonance imaging (at day 5 +/- 2 post-CA). Main secondary outcome was favourable neurological outcome (CPC score 1-2) at 180 days. In patients assigned to EGDHO, MAP (P < 0.001), and cerebral oxygenation during the first 12 h of ICU stay (P = 0.04) were higher. However, the percentage of voxels below an ADC score of 650.10(-6) mm(2)/s did not differ between both groups [16% vs. 12%, odds ratio 1.37, 95% confidence interval (CI) 0.95-0.98; P = 0.09]. Also, the number of patients with favourable neurological outcome at 180 days was similar (40% vs. 38%, odds ratio 0.98, 95% CI 0.41-2.33; P = 0.96). The number of serious adverse events was lower in patients assigned to EGDHO (P = 0.02). Conclusion Targeting a higher MAP in post-CA patients was safe and improved cerebral oxygenation but did not improve the extent of anoxic brain damage or neurological outcome.-
dc.description.sponsorshipR.L. is a senior clinical investigator of FWO Flanders. The authors want to thank all members of the medical staff and nursing team of the cardiac intensive care units of Ziekenhuis Oost-Limburg Genk and University Hospitals Leuven for their help and support throughout the study. We also want to thank Karin Hirsch and Michael Mlynash from Stanford University for their help with external validation of our DW-MRI analysis. Finally, we want to thank the Flemish government for the funding of the trial.-
dc.publisherOXFORD UNIV PRESS-
dc.rightsAll rights reserved. VC The Author(s) 2019. For permissions, please email:
dc.subject.otherCardiac arrest; Haemodynamics-
dc.subject.otherCardiac arrest; Haemodynamics-
dc.titleEarly goal-directed haemodynamic optimization of cerebral oxygenation in comatose survivors after cardiac arrest: the Neuroprotect post-cardiac arrest trial-
dc.typeJournal Contribution-
dc.description.notes[Ameloot, Koen; Ferdinande, Bert; Dupont, Matthias; Palmers, Pieter-Jan; Petit, Tibaut; Nuyens, Philippe; Maeremans, Joren; Dens, Jo] Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. [Ameloot, Koen; Petit, Tibaut; Nuyens, Philippe; Vanhaverbeke, Maarten; Belmans, Ann; Janssens, Stefan] Univ Hosp Leuven, Dept Cardiol, Leuven, Belgium. [Ameloot, Koen; De Deyne, Cathy; Eertmans, Ward; Maeremans, Joren; Dens, Jo] Univ Hasselt, Fac Med & Life Sci, Diepenbeek, Belgium. [De Deyne, Cathy; Eertmans, Ward; Vundelinckx, Joris] Ziekenhuis Oost Limburg, Dept Anesthesiol & Crit Care Med, Genk, Belgium. [Peeters, Ronald; Demaerel, Philippe] Univ Hosp Leuven, Dept Neurol, Leuven, Belgium. [Lemmens, Robin] Univ Hosp Leuven, Dept Radiol, Leuven, Belgium. [Lemmens, Robin] VIB, Ctr Brain & Dis Res, Neurobiol Lab, Leuven, Belgium. [Lemmens, Robin] Univ Leuven, KU Leuven, Dept Neurosci, Expt Neurol, Leuven, Belgium. [Lemmens, Robin] Univ Leuven, KU Leuven, LBI, Leuven, Belgium.-
item.fulltextWith Fulltext-
item.fullcitationAMELOOT, Koen; DE DEYNE, Cathy; EERTMANS, Ward; Ferdinande, Bert; DUPONT, Matthias; Palmers, Pieter-Jan; Petit, Tibaut; Nuyens, Philippe; MAEREMANS, Joren; Vundelinckx, Joris; Vanhaverbeke, Maarten; Belmans, Ann; Peeters, Ronald; Demaerel, Philippe; Lemmens, Robin; DENS, Jo & Janssens, Stefan (2019) Early goal-directed haemodynamic optimization of cerebral oxygenation in comatose survivors after cardiac arrest: the Neuroprotect post-cardiac arrest trial. In: EUROPEAN HEART JOURNAL, 40(22), p. 1804-1814.-
item.accessRightsRestricted Access-
item.contributorBelmans, Ann-
item.contributorDENS, Jo-
item.contributorLemmens, Robin-
item.contributorAMELOOT, Koen-
item.contributorFerdinande, Bert-
item.contributorVundelinckx, Joris-
item.contributorVanhaverbeke, Maarten-
item.contributorDemaerel, Philippe-
item.contributorPetit, Tibaut-
item.contributorPeeters, Ronald-
item.contributorPalmers, Pieter-Jan-
item.contributorMAEREMANS, Joren-
item.contributorDE DEYNE, Cathy-
item.contributorDUPONT, Matthias-
item.contributorJanssens, Stefan-
item.contributorNuyens, Philippe-
item.contributorEERTMANS, Ward-
item.validationecoom 2020-
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