Impact of blood pressure targets on central hemodynamics during intensive care after out-of-hospital cardiac arrest
Objectives: The aim was to investigate the advanced hemodynamic effects of the two MAP-targets during intensive care on systemic hemodynamics in comatose patients after cardiac arrest.Design: Secondary analysis of a randomized controlled trial.Setting: Primary vasopressor used was per protocol norep...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Grand, Johannes [verfasserIn] Møller, Jacob E. [verfasserIn] Hassager, Christian [verfasserIn] Schmidt, Henrik [verfasserIn] Mølstrøm, Simon [verfasserIn] Boesgaard, Søren [verfasserIn] Meyer, Martin Abild Stengaard [verfasserIn] Josiassen, Jakob [verfasserIn] Højgaard, Henrik Frederiksen [verfasserIn] Frydland, Martin [verfasserIn] Dahl, Jordi S. [verfasserIn] Obling, Laust Emil Roelsgaard [verfasserIn] Bak, Mikkel [verfasserIn] Lind Jørgensen, Vibeke [verfasserIn] Thomsen, Jakob Hartvig [verfasserIn] Wiberg, Sebastian [verfasserIn] Madsen, Søren Aalbæk [verfasserIn] Nyholm, Benjamin [verfasserIn] Kjaergaard, Jesper [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2023 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Resuscitation - Amsterdam [u.a.] : Elsevier Science, 1972, 194 |
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| Übergeordnetes Werk: |
volume:194 |
| DOI / URN: |
10.1016/j.resuscitation.2023.110094 |
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| Katalog-ID: |
ELV066576997 |
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| 024 | 7 | |a 10.1016/j.resuscitation.2023.110094 |2 doi | |
| 035 | |a (DE-627)ELV066576997 | ||
| 035 | |a (ELSEVIER)S0300-9572(23)00830-4 | ||
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| 100 | 1 | |a Grand, Johannes |e verfasserin |0 (orcid)0000-0002-5511-4668 |4 aut | |
| 245 | 1 | 0 | |a Impact of blood pressure targets on central hemodynamics during intensive care after out-of-hospital cardiac arrest |
| 264 | 1 | |c 2023 | |
| 336 | |a nicht spezifiziert |b zzz |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 520 | |a Objectives: The aim was to investigate the advanced hemodynamic effects of the two MAP-targets during intensive care on systemic hemodynamics in comatose patients after cardiac arrest.Design: Secondary analysis of a randomized controlled trial.Setting: Primary vasopressor used was per protocol norepinephrine. Hemodynamic monitoring was done with pulmonary artery catheters (PAC) and measurements were made on predefined time points. The primary endpoint of this substudy was the difference in cardiac index within 48 h from a repeated measurements-mixed model. Secondary endpoints included systemic vascular resistance index (SVRI), heart rate, and stroke volume index.Patients: Comatose survivors after out-of-hospital cardiac arrest.Interventions: The “Blood pressure and oxygenations targets after out-of-hospital cardiac arrest (BOX)”-trial was a randomized, controlled, double-blinded, multicenter-study comparing targeted mean arterial pressure (MAP) of 63 mmHg (MAP63) vs 77 mmHg (MAP77).Measurements and main results: Among 789 randomized patients, 730 (93%) patients were included in the hemodynamic substudy. From PAC-insertion (median 1 hours after ICU-admission) and the next 48 hours, the MAP77-group received significantly higher doses of norepinephrine (mean difference 0.09 µg/kg/min, 95% confidence interval (CI) 0.07–0.11, p group < 0.0001). Cardiac index was significantly increased (0.20 L/min/m2 (CI 0.12–0.28), p group < 0.0001) as was SVRI with an overall difference of (43 dynes m2/s/cm5 (CI 7–79); p group = 0.02). Heart rate was increased in the MAP77-group (4 beats/minute; CI 2–6, p group < 0.003), but stroke volume index was not (p group = 0.10).Conclusions: Targeted MAP at 77 mmHg compared to 63 mmHg resulted in a higher dose of norepinephrine, increased cardiac index and SVRI. Heart rate was also increased, but stroke volume index was not affected by a higher blood pressure target. | ||
| 650 | 4 | |a Cardiac Arrest | |
| 650 | 4 | |a Vasopressors | |
| 650 | 4 | |a Hemodynamic parameters | |
| 650 | 4 | |a Post-cardiac arrest syndrome | |
| 700 | 1 | |a Møller, Jacob E. |e verfasserin |4 aut | |
| 700 | 1 | |a Hassager, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Schmidt, Henrik |e verfasserin |4 aut | |
| 700 | 1 | |a Mølstrøm, Simon |e verfasserin |4 aut | |
| 700 | 1 | |a Boesgaard, Søren |e verfasserin |4 aut | |
| 700 | 1 | |a Meyer, Martin Abild Stengaard |e verfasserin |4 aut | |
| 700 | 1 | |a Josiassen, Jakob |e verfasserin |4 aut | |
| 700 | 1 | |a Højgaard, Henrik Frederiksen |e verfasserin |4 aut | |
| 700 | 1 | |a Frydland, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Dahl, Jordi S. |e verfasserin |4 aut | |
| 700 | 1 | |a Obling, Laust Emil Roelsgaard |e verfasserin |4 aut | |
| 700 | 1 | |a Bak, Mikkel |e verfasserin |4 aut | |
| 700 | 1 | |a Lind Jørgensen, Vibeke |e verfasserin |4 aut | |
| 700 | 1 | |a Thomsen, Jakob Hartvig |e verfasserin |4 aut | |
| 700 | 1 | |a Wiberg, Sebastian |e verfasserin |4 aut | |
| 700 | 1 | |a Madsen, Søren Aalbæk |e verfasserin |4 aut | |
| 700 | 1 | |a Nyholm, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Kjaergaard, Jesper |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Resuscitation |d Amsterdam [u.a.] : Elsevier Science, 1972 |g 194 |h Online-Ressource |w (DE-627)320488543 |w (DE-600)2010733-X |w (DE-576)099879042 |x 1873-1570 |7 nnns |
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10.1016/j.resuscitation.2023.110094 doi (DE-627)ELV066576997 (ELSEVIER)S0300-9572(23)00830-4 DE-627 ger DE-627 rda eng 610 VZ 44.80 bkl Grand, Johannes verfasserin (orcid)0000-0002-5511-4668 aut Impact of blood pressure targets on central hemodynamics during intensive care after out-of-hospital cardiac arrest 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives: The aim was to investigate the advanced hemodynamic effects of the two MAP-targets during intensive care on systemic hemodynamics in comatose patients after cardiac arrest.Design: Secondary analysis of a randomized controlled trial.Setting: Primary vasopressor used was per protocol norepinephrine. Hemodynamic monitoring was done with pulmonary artery catheters (PAC) and measurements were made on predefined time points. The primary endpoint of this substudy was the difference in cardiac index within 48 h from a repeated measurements-mixed model. Secondary endpoints included systemic vascular resistance index (SVRI), heart rate, and stroke volume index.Patients: Comatose survivors after out-of-hospital cardiac arrest.Interventions: The “Blood pressure and oxygenations targets after out-of-hospital cardiac arrest (BOX)”-trial was a randomized, controlled, double-blinded, multicenter-study comparing targeted mean arterial pressure (MAP) of 63 mmHg (MAP63) vs 77 mmHg (MAP77).Measurements and main results: Among 789 randomized patients, 730 (93%) patients were included in the hemodynamic substudy. From PAC-insertion (median 1 hours after ICU-admission) and the next 48 hours, the MAP77-group received significantly higher doses of norepinephrine (mean difference 0.09 µg/kg/min, 95% confidence interval (CI) 0.07–0.11, p group < 0.0001). Cardiac index was significantly increased (0.20 L/min/m2 (CI 0.12–0.28), p group < 0.0001) as was SVRI with an overall difference of (43 dynes m2/s/cm5 (CI 7–79); p group = 0.02). Heart rate was increased in the MAP77-group (4 beats/minute; CI 2–6, p group < 0.003), but stroke volume index was not (p group = 0.10).Conclusions: Targeted MAP at 77 mmHg compared to 63 mmHg resulted in a higher dose of norepinephrine, increased cardiac index and SVRI. Heart rate was also increased, but stroke volume index was not affected by a higher blood pressure target. Cardiac Arrest Vasopressors Hemodynamic parameters Post-cardiac arrest syndrome Møller, Jacob E. verfasserin aut Hassager, Christian verfasserin aut Schmidt, Henrik verfasserin aut Mølstrøm, Simon verfasserin aut Boesgaard, Søren verfasserin aut Meyer, Martin Abild Stengaard verfasserin aut Josiassen, Jakob verfasserin aut Højgaard, Henrik Frederiksen verfasserin aut Frydland, Martin verfasserin aut Dahl, Jordi S. verfasserin aut Obling, Laust Emil Roelsgaard verfasserin aut Bak, Mikkel verfasserin aut Lind Jørgensen, Vibeke verfasserin aut Thomsen, Jakob Hartvig verfasserin aut Wiberg, Sebastian verfasserin aut Madsen, Søren Aalbæk verfasserin aut Nyholm, Benjamin verfasserin aut Kjaergaard, Jesper verfasserin aut Enthalten in Resuscitation Amsterdam [u.a.] : Elsevier Science, 1972 194 Online-Ressource (DE-627)320488543 (DE-600)2010733-X (DE-576)099879042 1873-1570 nnns volume:194 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.80 Unfallmedizin Notfallmedizin VZ AR 194 |
| spelling |
10.1016/j.resuscitation.2023.110094 doi (DE-627)ELV066576997 (ELSEVIER)S0300-9572(23)00830-4 DE-627 ger DE-627 rda eng 610 VZ 44.80 bkl Grand, Johannes verfasserin (orcid)0000-0002-5511-4668 aut Impact of blood pressure targets on central hemodynamics during intensive care after out-of-hospital cardiac arrest 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives: The aim was to investigate the advanced hemodynamic effects of the two MAP-targets during intensive care on systemic hemodynamics in comatose patients after cardiac arrest.Design: Secondary analysis of a randomized controlled trial.Setting: Primary vasopressor used was per protocol norepinephrine. Hemodynamic monitoring was done with pulmonary artery catheters (PAC) and measurements were made on predefined time points. The primary endpoint of this substudy was the difference in cardiac index within 48 h from a repeated measurements-mixed model. Secondary endpoints included systemic vascular resistance index (SVRI), heart rate, and stroke volume index.Patients: Comatose survivors after out-of-hospital cardiac arrest.Interventions: The “Blood pressure and oxygenations targets after out-of-hospital cardiac arrest (BOX)”-trial was a randomized, controlled, double-blinded, multicenter-study comparing targeted mean arterial pressure (MAP) of 63 mmHg (MAP63) vs 77 mmHg (MAP77).Measurements and main results: Among 789 randomized patients, 730 (93%) patients were included in the hemodynamic substudy. From PAC-insertion (median 1 hours after ICU-admission) and the next 48 hours, the MAP77-group received significantly higher doses of norepinephrine (mean difference 0.09 µg/kg/min, 95% confidence interval (CI) 0.07–0.11, p group < 0.0001). Cardiac index was significantly increased (0.20 L/min/m2 (CI 0.12–0.28), p group < 0.0001) as was SVRI with an overall difference of (43 dynes m2/s/cm5 (CI 7–79); p group = 0.02). Heart rate was increased in the MAP77-group (4 beats/minute; CI 2–6, p group < 0.003), but stroke volume index was not (p group = 0.10).Conclusions: Targeted MAP at 77 mmHg compared to 63 mmHg resulted in a higher dose of norepinephrine, increased cardiac index and SVRI. Heart rate was also increased, but stroke volume index was not affected by a higher blood pressure target. Cardiac Arrest Vasopressors Hemodynamic parameters Post-cardiac arrest syndrome Møller, Jacob E. verfasserin aut Hassager, Christian verfasserin aut Schmidt, Henrik verfasserin aut Mølstrøm, Simon verfasserin aut Boesgaard, Søren verfasserin aut Meyer, Martin Abild Stengaard verfasserin aut Josiassen, Jakob verfasserin aut Højgaard, Henrik Frederiksen verfasserin aut Frydland, Martin verfasserin aut Dahl, Jordi S. verfasserin aut Obling, Laust Emil Roelsgaard verfasserin aut Bak, Mikkel verfasserin aut Lind Jørgensen, Vibeke verfasserin aut Thomsen, Jakob Hartvig verfasserin aut Wiberg, Sebastian verfasserin aut Madsen, Søren Aalbæk verfasserin aut Nyholm, Benjamin verfasserin aut Kjaergaard, Jesper verfasserin aut Enthalten in Resuscitation Amsterdam [u.a.] : Elsevier Science, 1972 194 Online-Ressource (DE-627)320488543 (DE-600)2010733-X (DE-576)099879042 1873-1570 nnns volume:194 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.80 Unfallmedizin Notfallmedizin VZ AR 194 |
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10.1016/j.resuscitation.2023.110094 doi (DE-627)ELV066576997 (ELSEVIER)S0300-9572(23)00830-4 DE-627 ger DE-627 rda eng 610 VZ 44.80 bkl Grand, Johannes verfasserin (orcid)0000-0002-5511-4668 aut Impact of blood pressure targets on central hemodynamics during intensive care after out-of-hospital cardiac arrest 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives: The aim was to investigate the advanced hemodynamic effects of the two MAP-targets during intensive care on systemic hemodynamics in comatose patients after cardiac arrest.Design: Secondary analysis of a randomized controlled trial.Setting: Primary vasopressor used was per protocol norepinephrine. Hemodynamic monitoring was done with pulmonary artery catheters (PAC) and measurements were made on predefined time points. The primary endpoint of this substudy was the difference in cardiac index within 48 h from a repeated measurements-mixed model. Secondary endpoints included systemic vascular resistance index (SVRI), heart rate, and stroke volume index.Patients: Comatose survivors after out-of-hospital cardiac arrest.Interventions: The “Blood pressure and oxygenations targets after out-of-hospital cardiac arrest (BOX)”-trial was a randomized, controlled, double-blinded, multicenter-study comparing targeted mean arterial pressure (MAP) of 63 mmHg (MAP63) vs 77 mmHg (MAP77).Measurements and main results: Among 789 randomized patients, 730 (93%) patients were included in the hemodynamic substudy. From PAC-insertion (median 1 hours after ICU-admission) and the next 48 hours, the MAP77-group received significantly higher doses of norepinephrine (mean difference 0.09 µg/kg/min, 95% confidence interval (CI) 0.07–0.11, p group < 0.0001). Cardiac index was significantly increased (0.20 L/min/m2 (CI 0.12–0.28), p group < 0.0001) as was SVRI with an overall difference of (43 dynes m2/s/cm5 (CI 7–79); p group = 0.02). Heart rate was increased in the MAP77-group (4 beats/minute; CI 2–6, p group < 0.003), but stroke volume index was not (p group = 0.10).Conclusions: Targeted MAP at 77 mmHg compared to 63 mmHg resulted in a higher dose of norepinephrine, increased cardiac index and SVRI. Heart rate was also increased, but stroke volume index was not affected by a higher blood pressure target. Cardiac Arrest Vasopressors Hemodynamic parameters Post-cardiac arrest syndrome Møller, Jacob E. verfasserin aut Hassager, Christian verfasserin aut Schmidt, Henrik verfasserin aut Mølstrøm, Simon verfasserin aut Boesgaard, Søren verfasserin aut Meyer, Martin Abild Stengaard verfasserin aut Josiassen, Jakob verfasserin aut Højgaard, Henrik Frederiksen verfasserin aut Frydland, Martin verfasserin aut Dahl, Jordi S. verfasserin aut Obling, Laust Emil Roelsgaard verfasserin aut Bak, Mikkel verfasserin aut Lind Jørgensen, Vibeke verfasserin aut Thomsen, Jakob Hartvig verfasserin aut Wiberg, Sebastian verfasserin aut Madsen, Søren Aalbæk verfasserin aut Nyholm, Benjamin verfasserin aut Kjaergaard, Jesper verfasserin aut Enthalten in Resuscitation Amsterdam [u.a.] : Elsevier Science, 1972 194 Online-Ressource (DE-627)320488543 (DE-600)2010733-X (DE-576)099879042 1873-1570 nnns volume:194 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.80 Unfallmedizin Notfallmedizin VZ AR 194 |
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10.1016/j.resuscitation.2023.110094 doi (DE-627)ELV066576997 (ELSEVIER)S0300-9572(23)00830-4 DE-627 ger DE-627 rda eng 610 VZ 44.80 bkl Grand, Johannes verfasserin (orcid)0000-0002-5511-4668 aut Impact of blood pressure targets on central hemodynamics during intensive care after out-of-hospital cardiac arrest 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives: The aim was to investigate the advanced hemodynamic effects of the two MAP-targets during intensive care on systemic hemodynamics in comatose patients after cardiac arrest.Design: Secondary analysis of a randomized controlled trial.Setting: Primary vasopressor used was per protocol norepinephrine. Hemodynamic monitoring was done with pulmonary artery catheters (PAC) and measurements were made on predefined time points. The primary endpoint of this substudy was the difference in cardiac index within 48 h from a repeated measurements-mixed model. Secondary endpoints included systemic vascular resistance index (SVRI), heart rate, and stroke volume index.Patients: Comatose survivors after out-of-hospital cardiac arrest.Interventions: The “Blood pressure and oxygenations targets after out-of-hospital cardiac arrest (BOX)”-trial was a randomized, controlled, double-blinded, multicenter-study comparing targeted mean arterial pressure (MAP) of 63 mmHg (MAP63) vs 77 mmHg (MAP77).Measurements and main results: Among 789 randomized patients, 730 (93%) patients were included in the hemodynamic substudy. From PAC-insertion (median 1 hours after ICU-admission) and the next 48 hours, the MAP77-group received significantly higher doses of norepinephrine (mean difference 0.09 µg/kg/min, 95% confidence interval (CI) 0.07–0.11, p group < 0.0001). Cardiac index was significantly increased (0.20 L/min/m2 (CI 0.12–0.28), p group < 0.0001) as was SVRI with an overall difference of (43 dynes m2/s/cm5 (CI 7–79); p group = 0.02). Heart rate was increased in the MAP77-group (4 beats/minute; CI 2–6, p group < 0.003), but stroke volume index was not (p group = 0.10).Conclusions: Targeted MAP at 77 mmHg compared to 63 mmHg resulted in a higher dose of norepinephrine, increased cardiac index and SVRI. Heart rate was also increased, but stroke volume index was not affected by a higher blood pressure target. Cardiac Arrest Vasopressors Hemodynamic parameters Post-cardiac arrest syndrome Møller, Jacob E. verfasserin aut Hassager, Christian verfasserin aut Schmidt, Henrik verfasserin aut Mølstrøm, Simon verfasserin aut Boesgaard, Søren verfasserin aut Meyer, Martin Abild Stengaard verfasserin aut Josiassen, Jakob verfasserin aut Højgaard, Henrik Frederiksen verfasserin aut Frydland, Martin verfasserin aut Dahl, Jordi S. verfasserin aut Obling, Laust Emil Roelsgaard verfasserin aut Bak, Mikkel verfasserin aut Lind Jørgensen, Vibeke verfasserin aut Thomsen, Jakob Hartvig verfasserin aut Wiberg, Sebastian verfasserin aut Madsen, Søren Aalbæk verfasserin aut Nyholm, Benjamin verfasserin aut Kjaergaard, Jesper verfasserin aut Enthalten in Resuscitation Amsterdam [u.a.] : Elsevier Science, 1972 194 Online-Ressource (DE-627)320488543 (DE-600)2010733-X (DE-576)099879042 1873-1570 nnns volume:194 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.80 Unfallmedizin Notfallmedizin VZ AR 194 |
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10.1016/j.resuscitation.2023.110094 doi (DE-627)ELV066576997 (ELSEVIER)S0300-9572(23)00830-4 DE-627 ger DE-627 rda eng 610 VZ 44.80 bkl Grand, Johannes verfasserin (orcid)0000-0002-5511-4668 aut Impact of blood pressure targets on central hemodynamics during intensive care after out-of-hospital cardiac arrest 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives: The aim was to investigate the advanced hemodynamic effects of the two MAP-targets during intensive care on systemic hemodynamics in comatose patients after cardiac arrest.Design: Secondary analysis of a randomized controlled trial.Setting: Primary vasopressor used was per protocol norepinephrine. Hemodynamic monitoring was done with pulmonary artery catheters (PAC) and measurements were made on predefined time points. The primary endpoint of this substudy was the difference in cardiac index within 48 h from a repeated measurements-mixed model. Secondary endpoints included systemic vascular resistance index (SVRI), heart rate, and stroke volume index.Patients: Comatose survivors after out-of-hospital cardiac arrest.Interventions: The “Blood pressure and oxygenations targets after out-of-hospital cardiac arrest (BOX)”-trial was a randomized, controlled, double-blinded, multicenter-study comparing targeted mean arterial pressure (MAP) of 63 mmHg (MAP63) vs 77 mmHg (MAP77).Measurements and main results: Among 789 randomized patients, 730 (93%) patients were included in the hemodynamic substudy. From PAC-insertion (median 1 hours after ICU-admission) and the next 48 hours, the MAP77-group received significantly higher doses of norepinephrine (mean difference 0.09 µg/kg/min, 95% confidence interval (CI) 0.07–0.11, p group < 0.0001). Cardiac index was significantly increased (0.20 L/min/m2 (CI 0.12–0.28), p group < 0.0001) as was SVRI with an overall difference of (43 dynes m2/s/cm5 (CI 7–79); p group = 0.02). Heart rate was increased in the MAP77-group (4 beats/minute; CI 2–6, p group < 0.003), but stroke volume index was not (p group = 0.10).Conclusions: Targeted MAP at 77 mmHg compared to 63 mmHg resulted in a higher dose of norepinephrine, increased cardiac index and SVRI. Heart rate was also increased, but stroke volume index was not affected by a higher blood pressure target. Cardiac Arrest Vasopressors Hemodynamic parameters Post-cardiac arrest syndrome Møller, Jacob E. verfasserin aut Hassager, Christian verfasserin aut Schmidt, Henrik verfasserin aut Mølstrøm, Simon verfasserin aut Boesgaard, Søren verfasserin aut Meyer, Martin Abild Stengaard verfasserin aut Josiassen, Jakob verfasserin aut Højgaard, Henrik Frederiksen verfasserin aut Frydland, Martin verfasserin aut Dahl, Jordi S. verfasserin aut Obling, Laust Emil Roelsgaard verfasserin aut Bak, Mikkel verfasserin aut Lind Jørgensen, Vibeke verfasserin aut Thomsen, Jakob Hartvig verfasserin aut Wiberg, Sebastian verfasserin aut Madsen, Søren Aalbæk verfasserin aut Nyholm, Benjamin verfasserin aut Kjaergaard, Jesper verfasserin aut Enthalten in Resuscitation Amsterdam [u.a.] : Elsevier Science, 1972 194 Online-Ressource (DE-627)320488543 (DE-600)2010733-X (DE-576)099879042 1873-1570 nnns volume:194 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.80 Unfallmedizin Notfallmedizin VZ AR 194 |
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Grand, Johannes @@aut@@ Møller, Jacob E. @@aut@@ Hassager, Christian @@aut@@ Schmidt, Henrik @@aut@@ Mølstrøm, Simon @@aut@@ Boesgaard, Søren @@aut@@ Meyer, Martin Abild Stengaard @@aut@@ Josiassen, Jakob @@aut@@ Højgaard, Henrik Frederiksen @@aut@@ Frydland, Martin @@aut@@ Dahl, Jordi S. @@aut@@ Obling, Laust Emil Roelsgaard @@aut@@ Bak, Mikkel @@aut@@ Lind Jørgensen, Vibeke @@aut@@ Thomsen, Jakob Hartvig @@aut@@ Wiberg, Sebastian @@aut@@ Madsen, Søren Aalbæk @@aut@@ Nyholm, Benjamin @@aut@@ Kjaergaard, Jesper @@aut@@ |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">ELV066576997</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20240114093603.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">240114s2023 xx |||||o 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1016/j.resuscitation.2023.110094</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)ELV066576997</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(ELSEVIER)S0300-9572(23)00830-4</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rda</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">VZ</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.80</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Grand, Johannes</subfield><subfield code="e">verfasserin</subfield><subfield code="0">(orcid)0000-0002-5511-4668</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Impact of blood pressure targets on central hemodynamics during intensive care after out-of-hospital cardiac arrest</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zzz</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Objectives: The aim was to investigate the advanced hemodynamic effects of the two MAP-targets during intensive care on systemic hemodynamics in comatose patients after cardiac arrest.Design: Secondary analysis of a randomized controlled trial.Setting: Primary vasopressor used was per protocol norepinephrine. Hemodynamic monitoring was done with pulmonary artery catheters (PAC) and measurements were made on predefined time points. The primary endpoint of this substudy was the difference in cardiac index within 48 h from a repeated measurements-mixed model. Secondary endpoints included systemic vascular resistance index (SVRI), heart rate, and stroke volume index.Patients: Comatose survivors after out-of-hospital cardiac arrest.Interventions: The “Blood pressure and oxygenations targets after out-of-hospital cardiac arrest (BOX)”-trial was a randomized, controlled, double-blinded, multicenter-study comparing targeted mean arterial pressure (MAP) of 63 mmHg (MAP63) vs 77 mmHg (MAP77).Measurements and main results: Among 789 randomized patients, 730 (93%) patients were included in the hemodynamic substudy. From PAC-insertion (median 1 hours after ICU-admission) and the next 48 hours, the MAP77-group received significantly higher doses of norepinephrine (mean difference 0.09 µg/kg/min, 95% confidence interval (CI) 0.07–0.11, p group < 0.0001). Cardiac index was significantly increased (0.20 L/min/m2 (CI 0.12–0.28), p group < 0.0001) as was SVRI with an overall difference of (43 dynes m2/s/cm5 (CI 7–79); p group = 0.02). Heart rate was increased in the MAP77-group (4 beats/minute; CI 2–6, p group < 0.003), but stroke volume index was not (p group = 0.10).Conclusions: Targeted MAP at 77 mmHg compared to 63 mmHg resulted in a higher dose of norepinephrine, increased cardiac index and SVRI. 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Grand, Johannes |
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Grand, Johannes Møller, Jacob E. Hassager, Christian Schmidt, Henrik Mølstrøm, Simon Boesgaard, Søren Meyer, Martin Abild Stengaard Josiassen, Jakob Højgaard, Henrik Frederiksen Frydland, Martin Dahl, Jordi S. Obling, Laust Emil Roelsgaard Bak, Mikkel Lind Jørgensen, Vibeke Thomsen, Jakob Hartvig Wiberg, Sebastian Madsen, Søren Aalbæk Nyholm, Benjamin Kjaergaard, Jesper |
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10.1016/j.resuscitation.2023.110094 |
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impact of blood pressure targets on central hemodynamics during intensive care after out-of-hospital cardiac arrest |
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Impact of blood pressure targets on central hemodynamics during intensive care after out-of-hospital cardiac arrest |
| abstract |
Objectives: The aim was to investigate the advanced hemodynamic effects of the two MAP-targets during intensive care on systemic hemodynamics in comatose patients after cardiac arrest.Design: Secondary analysis of a randomized controlled trial.Setting: Primary vasopressor used was per protocol norepinephrine. Hemodynamic monitoring was done with pulmonary artery catheters (PAC) and measurements were made on predefined time points. The primary endpoint of this substudy was the difference in cardiac index within 48 h from a repeated measurements-mixed model. Secondary endpoints included systemic vascular resistance index (SVRI), heart rate, and stroke volume index.Patients: Comatose survivors after out-of-hospital cardiac arrest.Interventions: The “Blood pressure and oxygenations targets after out-of-hospital cardiac arrest (BOX)”-trial was a randomized, controlled, double-blinded, multicenter-study comparing targeted mean arterial pressure (MAP) of 63 mmHg (MAP63) vs 77 mmHg (MAP77).Measurements and main results: Among 789 randomized patients, 730 (93%) patients were included in the hemodynamic substudy. From PAC-insertion (median 1 hours after ICU-admission) and the next 48 hours, the MAP77-group received significantly higher doses of norepinephrine (mean difference 0.09 µg/kg/min, 95% confidence interval (CI) 0.07–0.11, p group < 0.0001). Cardiac index was significantly increased (0.20 L/min/m2 (CI 0.12–0.28), p group < 0.0001) as was SVRI with an overall difference of (43 dynes m2/s/cm5 (CI 7–79); p group = 0.02). Heart rate was increased in the MAP77-group (4 beats/minute; CI 2–6, p group < 0.003), but stroke volume index was not (p group = 0.10).Conclusions: Targeted MAP at 77 mmHg compared to 63 mmHg resulted in a higher dose of norepinephrine, increased cardiac index and SVRI. Heart rate was also increased, but stroke volume index was not affected by a higher blood pressure target. |
| abstractGer |
Objectives: The aim was to investigate the advanced hemodynamic effects of the two MAP-targets during intensive care on systemic hemodynamics in comatose patients after cardiac arrest.Design: Secondary analysis of a randomized controlled trial.Setting: Primary vasopressor used was per protocol norepinephrine. Hemodynamic monitoring was done with pulmonary artery catheters (PAC) and measurements were made on predefined time points. The primary endpoint of this substudy was the difference in cardiac index within 48 h from a repeated measurements-mixed model. Secondary endpoints included systemic vascular resistance index (SVRI), heart rate, and stroke volume index.Patients: Comatose survivors after out-of-hospital cardiac arrest.Interventions: The “Blood pressure and oxygenations targets after out-of-hospital cardiac arrest (BOX)”-trial was a randomized, controlled, double-blinded, multicenter-study comparing targeted mean arterial pressure (MAP) of 63 mmHg (MAP63) vs 77 mmHg (MAP77).Measurements and main results: Among 789 randomized patients, 730 (93%) patients were included in the hemodynamic substudy. From PAC-insertion (median 1 hours after ICU-admission) and the next 48 hours, the MAP77-group received significantly higher doses of norepinephrine (mean difference 0.09 µg/kg/min, 95% confidence interval (CI) 0.07–0.11, p group < 0.0001). Cardiac index was significantly increased (0.20 L/min/m2 (CI 0.12–0.28), p group < 0.0001) as was SVRI with an overall difference of (43 dynes m2/s/cm5 (CI 7–79); p group = 0.02). Heart rate was increased in the MAP77-group (4 beats/minute; CI 2–6, p group < 0.003), but stroke volume index was not (p group = 0.10).Conclusions: Targeted MAP at 77 mmHg compared to 63 mmHg resulted in a higher dose of norepinephrine, increased cardiac index and SVRI. Heart rate was also increased, but stroke volume index was not affected by a higher blood pressure target. |
| abstract_unstemmed |
Objectives: The aim was to investigate the advanced hemodynamic effects of the two MAP-targets during intensive care on systemic hemodynamics in comatose patients after cardiac arrest.Design: Secondary analysis of a randomized controlled trial.Setting: Primary vasopressor used was per protocol norepinephrine. Hemodynamic monitoring was done with pulmonary artery catheters (PAC) and measurements were made on predefined time points. The primary endpoint of this substudy was the difference in cardiac index within 48 h from a repeated measurements-mixed model. Secondary endpoints included systemic vascular resistance index (SVRI), heart rate, and stroke volume index.Patients: Comatose survivors after out-of-hospital cardiac arrest.Interventions: The “Blood pressure and oxygenations targets after out-of-hospital cardiac arrest (BOX)”-trial was a randomized, controlled, double-blinded, multicenter-study comparing targeted mean arterial pressure (MAP) of 63 mmHg (MAP63) vs 77 mmHg (MAP77).Measurements and main results: Among 789 randomized patients, 730 (93%) patients were included in the hemodynamic substudy. From PAC-insertion (median 1 hours after ICU-admission) and the next 48 hours, the MAP77-group received significantly higher doses of norepinephrine (mean difference 0.09 µg/kg/min, 95% confidence interval (CI) 0.07–0.11, p group < 0.0001). Cardiac index was significantly increased (0.20 L/min/m2 (CI 0.12–0.28), p group < 0.0001) as was SVRI with an overall difference of (43 dynes m2/s/cm5 (CI 7–79); p group = 0.02). Heart rate was increased in the MAP77-group (4 beats/minute; CI 2–6, p group < 0.003), but stroke volume index was not (p group = 0.10).Conclusions: Targeted MAP at 77 mmHg compared to 63 mmHg resulted in a higher dose of norepinephrine, increased cardiac index and SVRI. Heart rate was also increased, but stroke volume index was not affected by a higher blood pressure target. |
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| title_short |
Impact of blood pressure targets on central hemodynamics during intensive care after out-of-hospital cardiac arrest |
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Møller, Jacob E. Hassager, Christian Schmidt, Henrik Mølstrøm, Simon Boesgaard, Søren Meyer, Martin Abild Stengaard Josiassen, Jakob Højgaard, Henrik Frederiksen Frydland, Martin Dahl, Jordi S. Obling, Laust Emil Roelsgaard Bak, Mikkel Lind Jørgensen, Vibeke Thomsen, Jakob Hartvig Wiberg, Sebastian Madsen, Søren Aalbæk Nyholm, Benjamin Kjaergaard, Jesper |
| author2Str |
Møller, Jacob E. Hassager, Christian Schmidt, Henrik Mølstrøm, Simon Boesgaard, Søren Meyer, Martin Abild Stengaard Josiassen, Jakob Højgaard, Henrik Frederiksen Frydland, Martin Dahl, Jordi S. Obling, Laust Emil Roelsgaard Bak, Mikkel Lind Jørgensen, Vibeke Thomsen, Jakob Hartvig Wiberg, Sebastian Madsen, Søren Aalbæk Nyholm, Benjamin Kjaergaard, Jesper |
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| doi_str |
10.1016/j.resuscitation.2023.110094 |
| up_date |
2024-07-06T18:15:04.624Z |
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1803854497318961152 |
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