Ventilation management and outcomes in out-of-hospital cardiac arrest: a protocol for a preplanned secondary analysis of the TTM2 trial

. 2022 Mar 03 ; 12 (3) : e058001. [epub] 20220303

Jazyk angličtina Země Anglie, Velká Británie Médium electronic

Typ dokumentu protokol klinické studie, časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/pmid35241476
Odkazy

PubMed 35241476
PubMed Central PMC8896064
DOI 10.1136/bmjopen-2021-058001
PII: bmjopen-2021-058001
Knihovny.cz E-zdroje

INTRODUCTION: Mechanical ventilation is a fundamental component in the management of patients post cardiac arrest. However, the ventilator settings and the gas-exchange targets used after cardiac arrest may not be optimal to minimise post-anoxic secondary brain injury. Therefore, questions remain regarding the best ventilator management in such patients. METHODS AND ANALYSIS: This is a preplanned analysis of the international randomised controlled trial, targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest (OHCA)-target temperature management 2 (TTM2). The primary objective is to describe ventilatory settings and gas exchange in patients who required invasive mechanical ventilation and included in the TTM2 trial. Secondary objectives include evaluating the association of ventilator settings and gas-exchange values with 6 months mortality and neurological outcome. Adult patients after an OHCA who were included in the TTM2 trial and who received invasive mechanical ventilation will be eligible for this analysis. Data collected in the TTM2 trial that will be analysed include patients' prehospital characteristics, clinical examination, ventilator settings and arterial blood gases recorded at hospital and intensive care unit (ICU) admission and daily during ICU stay. ETHICS AND DISSEMINATION: The TTM2 study has been approved by the regional ethics committee at Lund University and by all relevant ethics boards in participating countries. No further ethical committee approval is required for this secondary analysis. Data will be disseminated to the scientific community by abstracts and by original articles submitted to peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT02908308.

Copenhagen Trial Unit Centre for Clinical Intervention Research Copenhagen University Hospital Copenhagen UK

Department of Anaesthesia and Intensive Care Biomedical and Clinical Sciences Linköping University Linköping Sweden

Department of Anaesthesia University Hospitals Bristol NHS Foundation Trust Bristol UK

Department of Anaesthesiology and Intensive Care Medicine University of Gothenburg Gothenburg Sweden

Department of Anesthesia and Critical Care San Martino Policlinico Hospital IRCCS for Oncology and Neuroscience Genoa Italy

Department of Anesthesiology and Surgical Trauma Intensive Care Hospital Clinic Universitari de València Universitat de València Valencia Spain

Department of Clinical Medicine Anaesthesiology and Intensive Care Lund University Lund Sweden

Department of Clinical Sciences Lund Anaesthesia and Intensive Care and Clinical Sciences Helsingborg Helsingborg Hospital Lund University Lund Sweden

Department of Clinical Sciences Lund Cardiology Skåne University Hospital Lund University Lund Lund UK

Department of Clinical Sciences Lund University Lund Sweden

Department of Critical Care George Institute for Global Health Newtown New South Wales Australia

Department of Intensive Care Faculty of Health Deakin University Burwood Victoria Australia

Department of Intensive Care Medicine Hopital Erasme Université Libre de Bruxelles Brussels Belgium

Department of Intensive Care Wellington Hospital Wellington New Zealand

Department of Internal Medicine Faculty of Medicine in Hradec Králové Charles University Prague Czech Republic

Department of Medicine Center for Resuscitation Science Karolinska Institutet Solna Sweden

Department of Medicine University of Barcelona Barcelona Spain Genoa Italy

Department of of Clinical Sciences Lund Lund University Lund Sweden

Department of Operation and Intensive Care Hallands Hospital Halmstad Halland Sweden

Dipartimento di Scienze Chirurgiche e Diagnostiche Università degli Studi di Genova Genoa Italy

Dipartimento di Scienze Chirurgiche e Diagnostiche University of Genoa Genoa Italy

Division of Intensive Care and Emergency Medicine Deptartment of Medicine Medizinische Universität Innsbruck Innsbruck Austria

Institute of Intensive Care Medicine Zurich Switzerland University Hospital of Zürich Zürich Switzerland

Monash University Melbourne Victoria Australia Melbourne Ireland

St George Hospital Sydney New South Wales Australia

Zobrazit více v PubMed

Kim Y-M, Yim H-W, Jeong S-H, et al. . Does therapeutic hypothermia benefit adult cardiac arrest patients presenting with non-shockable initial rhythms?: a systematic review and meta-analysis of randomized and non-randomized studies. Resuscitation 2012;83:188–96. 10.1016/j.resuscitation.2011.07.031 PubMed DOI

Lundbye JB, Rai M, Ramu B, et al. . Therapeutic hypothermia is associated with improved neurologic outcome and survival in cardiac arrest survivors of non-shockable rhythms. Resuscitation 2012;83:202–7. 10.1016/j.resuscitation.2011.08.005 PubMed DOI

Peberdy MA, Callaway CW, Neumar RW, et al. . Part 9: post-cardiac arrest care: 2010 American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2010;122:S768–86. 10.1161/CIRCULATIONAHA.110.971002 PubMed DOI

Nielsen N, Wetterslev J, Cronberg T, et al. . Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med 2013;369:2197–206. 10.1056/NEJMoa1310519 PubMed DOI

Mentzelopoulos SD, Malachias S, Chamos C, et al. . Vasopressin, steroids, and epinephrine and neurologically favorable survival after in-hospital cardiac arrest. JAMA 2013;310:270. 10.1001/jama.2013.7832 PubMed DOI

Morrison LJ, Neumar RW, Zimmerman JL, et al. . Strategies for improving survival after in-hospital cardiac arrest in the United States: 2013 consensus recommendations. Circulation 2013;127:1538–63. 10.1161/CIR.0b013e31828b2770 PubMed DOI

Bernard SA, Gray TW, Buist MD, et al. . Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002;346:557–63. 10.1056/NEJMoa003289 PubMed DOI

Hypothermia after Cardiac Arrest Study Group . Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002;346:549–56. 10.1056/NEJMoa012689 PubMed DOI

Harmon MBA, van Meenen DMP, van der Veen ALIP, et al. . Practice of mechanical ventilation in cardiac arrest patients and effects of targeted temperature management: a substudy of the targeted temperature management trial. Resuscitation 2018;129:29–36. 10.1016/j.resuscitation.2018.04.040 PubMed DOI

Sutherasan Y, Peñuelas O, Muriel A, et al. . Management and outcome of mechanically ventilated patients after cardiac arrest. Crit Care 2015;19:215. 10.1186/s13054-015-0922-9 PubMed DOI PMC

McHugh GS, Engel DC, Butcher I, et al. . Prognostic value of secondary insults in traumatic brain injury: results from the impact study. J Neurotrauma 2007;24:287–93. 10.1089/neu.2006.0031 PubMed DOI

Young PJ, Bailey M, Bellomo R, et al. . Conservative or liberal oxygen therapy in adults after cardiac arrest. Resuscitation 2020;157:15–22. 10.1016/j.resuscitation.2020.09.036 PubMed DOI

Palmer E, Post B, Klapaukh R, et al. . The association between supraphysiologic arterial oxygen levels and mortality in critically ill patients. A multicenter observational cohort study. Am J Respir Crit Care Med 2019;200:1373–80. 10.1164/rccm.201904-0849OC PubMed DOI PMC

Y-N N, Wang Y-M, Liang B-M. The effect of hyperoxia on mortality in critically ill patients: a systematic review and meta analysis. BMC Pulm Med 2019;19:53. PubMed PMC

Lilja G, Nielsen N, Ullén S, et al. . Protocol for outcome reporting and follow-up in the targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest trial (TTM2). Resuscitation 2020;150:104–12. 10.1016/j.resuscitation.2020.03.004 PubMed DOI

Roberts BW, Kilgannon JH, Chansky ME, et al. . Association between Postresuscitation partial pressure of arterial carbon dioxide and neurological outcome in patients with Post–Cardiac arrest syndrome. Circulation 2013;127:2107–13. 10.1161/CIRCULATIONAHA.112.000168 PubMed DOI

Koutsoukou A, Perraki H, Raftopoulou A, et al. . Respiratory mechanics in brain-damaged patients. Intensive Care Med 2006;32:1947–54. 10.1007/s00134-006-0406-0 PubMed DOI

Patel JK, Kataya A, Parikh PB. Association between intra- and post-arrest hyperoxia on mortality in adults with cardiac arrest: a systematic review and meta-analysis. Resuscitation 2018;127:83–8. 10.1016/j.resuscitation.2018.04.008 PubMed DOI

Robba C, Ortu A, Bilotta F, et al. . Extracorporeal membrane oxygenation for adult respiratory distress syndrome in trauma patients. J Trauma Acute Care Surg 2017;82:165–73. 10.1097/TA.0000000000001276 PubMed DOI

Pilcher J, Weatherall M, Shirtcliffe P, et al. . The effect of hyperoxia following cardiac arrest – a systematic review and meta-analysis of animal trials. Resuscitation 2012;83:417–22. 10.1016/j.resuscitation.2011.12.021 PubMed DOI

Wang C-H, Chang W-T, Huang C-H, et al. . The effect of hyperoxia on survival following adult cardiac arrest: a systematic review and meta-analysis of observational studies. Resuscitation 2014;85:1142–8. 10.1016/j.resuscitation.2014.05.021 PubMed DOI

Roberts BW, Kilgannon J, Chansky ME, et al. . Association between initial prescribed minute ventilation and post-resuscitation partial pressure of arterial carbon dioxide in patients with post-cardiac arrest syndrome. Ann Intensive Care 2014;4:9. 10.1186/2110-5820-4-9 PubMed DOI PMC

Eastwood GM, Nichol A. Optimal ventilator settings after return of spontaneous circulation. Curr Opin Crit Care 2020;26:251–8. 10.1097/MCC.0000000000000720 PubMed DOI

Eastwood GM, Young PJ, Bellomo R. The impact of oxygen and carbon dioxide management on outcome after cardiac arrest. Curr Opin Crit Care 2014;20:266–72. 10.1097/MCC.0000000000000084 PubMed DOI

Karalapillai D, Weinberg L, Peyton P, et al. . Effect of intraoperative low tidal volume vs conventional tidal volume on postoperative pulmonary complications in patients undergoing major surgery. JAMA 2020;324:848. 10.1001/jama.2020.12866 PubMed DOI PMC

Serpa Neto A, Simonis FD, Barbas CSV, et al. . Association between tidal volume size, duration of ventilation, and sedation needs in patients without acute respiratory distress syndrome: an individual patient data meta-analysis. Intensive Care Med 2014;40:950–7. 10.1007/s00134-014-3318-4 PubMed DOI

Caricato A, Conti G, Della Corte F, et al. . Effects of PEEP on the intracranial system of patients with head injury and subarachnoid hemorrhage: the role of respiratory system compliance. J Trauma 2005;58:571–6. 10.1097/01.TA.0000152806.19198.DB PubMed DOI

Tejerina E, Pelosi P, Muriel A, et al. . Association between ventilatory settings and development of acute respiratory distress syndrome in mechanically ventilated patients due to brain injury. J Crit Care 2017;38:341–5. 10.1016/j.jcrc.2016.11.010 PubMed DOI

Neto AS, Barbas CSV, Simonis FD, et al. . Epidemiological characteristics, practice of ventilation, and clinical outcome in patients at risk of acute respiratory distress syndrome in intensive care units from 16 countries (PRoVENT): an international, multicentre, prospective study. Lancet Respir Med 2016;4:882–93. 10.1016/S2213-2600(16)30305-8 PubMed DOI

Nolan JP, Sandroni C, Böttiger BW, et al. . European resuscitation Council and European Society of intensive care medicine guidelines 2021: post-resuscitation care. Resuscitation 2021;161:220–69. 10.1016/j.resuscitation.2021.02.012 PubMed DOI

Writing Group for the PReVENT Investigators, Simonis FD, Serpa Neto A, et al. . Effect of a low vs intermediate tidal volume strategy on Ventilator-Free days in intensive care unit patients without ARDS: a randomized clinical trial. JAMA 2018;320:320. 10.1001/jama.2018.14280 PubMed DOI PMC

Serpa Neto A, Deliberato RO, Johnson AEW, et al. . Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts. Intensive Care Med 2018;44:1914–22. 10.1007/s00134-018-5375-6 PubMed DOI

Toufen Junior C, De Santis Santiago RR, Hirota AS, et al. . Driving pressure and long-term outcomes in moderate/severe acute respiratory distress syndrome. Ann Intensive Care 2018;8:119. 10.1186/s13613-018-0469-4 PubMed DOI PMC

Tonetti T, Vasques F, Rapetti F, et al. . Driving pressure and mechanical power: new targets for VILI prevention. Ann Transl Med 2017;5:286. 10.21037/atm.2017.07.08 PubMed DOI PMC

Zobrazit více v PubMed

ClinicalTrials.gov
NCT02908308

Najít záznam

Citační ukazatele

Nahrávání dat ...

Možnosti archivace

Nahrávání dat ...