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

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Oxygen targets and 6-month outcome after out of hospital cardiac arrest: a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial

Ventilatory settings in the initial 72 h and their association with outcome in out-of-hospital cardiac arrest patients: a preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest (TTM2) trial

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NCT02908308