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http://hdl.handle.net/1942/40641
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DC Field | Value | Language |
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dc.contributor.author | Niemela, Ville | - |
dc.contributor.author | Siddiqui, Faiza | - |
dc.contributor.author | AMELOOT, Koen | - |
dc.contributor.author | Reinikainen, Matti | - |
dc.contributor.author | Grand, Johannes | - |
dc.contributor.author | Hastbacka, Johanna | - |
dc.contributor.author | Hassager, Christian | - |
dc.contributor.author | Kjaergaard, Jesper | - |
dc.contributor.author | Aneman, Anders | - |
dc.contributor.author | Tiainen, Marjaana | - |
dc.contributor.author | Nielsen, Niklas | - |
dc.contributor.author | Olsen, Markus Harboe | - |
dc.contributor.author | Jorgensen, Caroline Kamp | - |
dc.contributor.author | Petersen, Johanne Juul | - |
dc.contributor.author | Dankiewicz, Josef | - |
dc.contributor.author | Saxena, Manoj | - |
dc.contributor.author | Jakobsen, Janus C. | - |
dc.contributor.author | Skrifvars, Markus B. | - |
dc.date.accessioned | 2023-08-01T10:16:59Z | - |
dc.date.available | 2023-08-01T10:16:59Z | - |
dc.date.issued | 2023 | - |
dc.date.submitted | 2023-08-01T09:54:10Z | - |
dc.identifier.citation | RESUSCITATION, 189 (Art N° 109862) | - |
dc.identifier.uri | http://hdl.handle.net/1942/40641 | - |
dc.description.abstract | Purpose: Guidelines recommend targeting mean arterial pressure (MAP) > 65 mmHg in patients after cardiac arrest (CA). Recent trials have studied the effects of targeting a higher MAP as compared to a lower MAP after CA. We performed a systematic review and individual patient data meta analysis to investigate the effects of higher versus lower MAP targets on patient outcome.Method: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, LILACS, BIOSIS, CINAHL, Scopus, the Web of Science Core Collection, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry, Google Scholar and the Turning Research into Practice database to identify trials randomizing patients to higher (>71 mmHg) or lower (<70 mmHg) MAP targets after CA and resuscitation. We used the Cochrane Risk of Bias tool, version 2 (RoB 2) to assess for risk of bias. The primary outcomes were 180-day all-cause mortality and poor neurologic recovery defined by a modified Rankin score of 4-6 or a cerebral performance category score of 3-5.Results: Four eligible clinical trials were identified, randomizing a total of 1,087 patients. All the included trials were assessed as having a low risk for bias. The risk ratio (RR) with 95% confidence interval for 180-day all-cause mortality for a higher versus a lower MAP target was 1.08 (0.92-1.26) and for poor neurologic recovery 1.01 (0.86-1.19). Trial sequential analysis showed that a 25% or higher treatment effect, i.e., RR < 0.75, can be excluded. No difference in serious adverse events was found between the higher and lower MAP groups.Conclusions: Targeting a higher MAP compared to a lower MAP is unlikely to reduce mortality or improve neurologic recovery after CA. Only a large treatment effect above 25% (RR < 0.75) could be excluded, and future studies are needed to investigate if relevant but lower treatment effect exists. Targeting a higher MAP was not associated with any increase in adverse effects. | - |
dc.language.iso | en | - |
dc.publisher | ELSEVIER IRELAND LTD | - |
dc.rights | 2023 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons. org/licenses/by-nc-nd/4.0/). | - |
dc.subject.other | Cardiac arrest | - |
dc.subject.other | Target | - |
dc.subject.other | Blood pressure | - |
dc.subject.other | Meta-analysis | - |
dc.subject.other | Systematic review | - |
dc.title | Higher versus lower blood pressure targets after cardiac arrest: Systematic review with individual patient data meta-analysis | - |
dc.type | Journal Contribution | - |
dc.identifier.volume | 189 | - |
local.format.pages | 10 | - |
local.bibliographicCitation.jcat | A1 | - |
dc.description.notes | Skrifvars, MB (corresponding author), Meilahti Hosp MEM2B, Haartmaninkatu 9, Helsinki 00290, HUS, Finland. | - |
dc.description.notes | markus.skrifvars@hus.fi | - |
local.publisher.place | ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND | - |
local.type.refereed | Refereed | - |
local.type.specified | Review | - |
local.bibliographicCitation.artnr | 109862 | - |
dc.identifier.doi | 10.1016/j.resuscitation.2023.109862 | - |
dc.identifier.pmid | 37295549 | - |
dc.identifier.isi | 001027594300001 | - |
dc.contributor.orcid | Jorgensen, Caroline Kamp/0000-0002-7756-4694; Olsen, Markus | - |
dc.contributor.orcid | Harboe/0000-0003-0981-0723; Grand, Johannes/0000-0002-5511-4668 | - |
local.provider.type | wosris | - |
local.description.affiliation | [Niemela, Ville; Aneman, Anders] Helsinki Univ Hosp, Dept Anaesthes & Intens Care, Helsinki, Finland. | - |
local.description.affiliation | [Niemela, Ville; Aneman, Anders; Tiainen, Marjaana; Skrifvars, Markus B.] Univ Helsinki, Helsinki, Finland. | - |
local.description.affiliation | [Siddiqui, Faiza; Olsen, Markus Harboe; Jorgensen, Caroline Kamp; Petersen, Johanne Juul; Jakobsen, Janus C.] Copenhagen Univ Hosp, Rigshosp, Ctr Clin Intervent Res, Copenhagen Trial Unit, Copenhagen, Denmark. | - |
local.description.affiliation | [Ameloot, Koen] Ziekenhuis Oost Limburg, Dept Cardiol, Genk, Belgium. | - |
local.description.affiliation | [Ameloot, Koen] Univ Hosp Leuven, Dept Cardiol, Leuven, Belgium. | - |
local.description.affiliation | [Ameloot, Koen] Univ Hasselt, Fac Med & Life Sci, Diepenbeek, Belgium. | - |
local.description.affiliation | [Reinikainen, Matti] Kuopio Univ Hosp, Dept Anaesthesiol & Intens Care, Kuopio, Finland. | - |
local.description.affiliation | [Reinikainen, Matti] Univ Eastern Finland, Kuopio, Finland. | - |
local.description.affiliation | [Grand, Johannes; Hassager, Christian; Kjaergaard, Jesper] Copenhagen Univ Hosp, Rigshosp, Dept Cardiol, Copenhagen, Denmark. | - |
local.description.affiliation | [Grand, Johannes] Tampere Univ Hosp, Dept Anaesthesiol & Intens Care, Tampere, Finland. | - |
local.description.affiliation | [Grand, Johannes] Tampere Univ, Tampere, Finland. | - |
local.description.affiliation | [Aneman, Anders] Macquarie Univ, Univ New South Wales, Liverpool Hosp, Fac Med & Hlth Sci,South Western Clin Sch,Intens C, Sydney, Australia. | - |
local.description.affiliation | [Tiainen, Marjaana] Helsinki Univ Hosp, Dept Neurol, Helsinki, Finland. | - |
local.description.affiliation | Lund Univ, Lund, Sweden. | - |
local.description.affiliation | [Nielsen, Niklas] Helsingborg Hosp, Dept Clin Sci Lund, Anaesthes & Intens Care, Lund, Sweden. | - |
local.description.affiliation | Skane Univ Hosp, Clin Studies Sweden Forum South, Lund, Sweden. | - |
local.description.affiliation | Helsingborg Hosp, Anaesthes & Intens Care, Lund, Sweden. | - |
local.description.affiliation | Lund Univ, Skane Univ Hosp, Dept Clin Sci Lund, Cardiol, Lund, Sweden. | - |
local.description.affiliation | Copenhagen Univ Hosp, Rigshosp, Neurosci Ctr, Dept Neuroanaesthesiol, Copenhagen, Denmark. | - |
local.description.affiliation | Univ New South Wales, South Western Clin Sch, Sydney, Australia. | - |
local.description.affiliation | Univ New South Wales, George Inst Global Hlth, Crit Care Div, Sydney, Australia. | - |
local.description.affiliation | Univ Southern Denmark, Fac Hlth Sci, Dept Reg Hlth Res, Odense, Denmark. | - |
local.description.affiliation | Helsinki Univ Hosp, Dept Emergency Care & Serv, Helsinki, Finland. | - |
local.description.affiliation | [Skrifvars, Markus B.] Meilahti Hosp MEM2B, Haartmaninkatu 9, Helsinki 00290, HUS, Finland. | - |
local.uhasselt.international | yes | - |
item.accessRights | Open Access | - |
item.contributor | Niemela, Ville | - |
item.contributor | Siddiqui, Faiza | - |
item.contributor | AMELOOT, Koen | - |
item.contributor | Reinikainen, Matti | - |
item.contributor | Grand, Johannes | - |
item.contributor | Hastbacka, Johanna | - |
item.contributor | Hassager, Christian | - |
item.contributor | Kjaergaard, Jesper | - |
item.contributor | Aneman, Anders | - |
item.contributor | Tiainen, Marjaana | - |
item.contributor | Nielsen, Niklas | - |
item.contributor | Olsen, Markus Harboe | - |
item.contributor | Jorgensen, Caroline Kamp | - |
item.contributor | Petersen, Johanne Juul | - |
item.contributor | Dankiewicz, Josef | - |
item.contributor | Saxena, Manoj | - |
item.contributor | Jakobsen, Janus C. | - |
item.contributor | Skrifvars, Markus B. | - |
item.fullcitation | Niemela, Ville; Siddiqui, Faiza; AMELOOT, Koen; Reinikainen, Matti; Grand, Johannes; Hastbacka, Johanna; Hassager, Christian; Kjaergaard, Jesper; Aneman, Anders; Tiainen, Marjaana; Nielsen, Niklas; Olsen, Markus Harboe; Jorgensen, Caroline Kamp; Petersen, Johanne Juul; Dankiewicz, Josef; Saxena, Manoj; Jakobsen, Janus C. & Skrifvars, Markus B. (2023) Higher versus lower blood pressure targets after cardiac arrest: Systematic review with individual patient data meta-analysis. In: RESUSCITATION, 189 (Art N° 109862). | - |
item.fulltext | With Fulltext | - |
crisitem.journal.issn | 0300-9572 | - |
crisitem.journal.eissn | 1873-1570 | - |
Appears in Collections: | Research publications |
Files in This Item:
File | Description | Size | Format | |
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Higher versus lower blood pressure targets after cardiac arrest_ Systematic review with individual patient data meta-analysis.pdf | Published version | 1.22 MB | Adobe PDF | View/Open |
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