Serial assessments of cardiac output and mixed venous oxygen saturation in comatose patients after out-of-hospital cardiac arrest

Aim To assess the association with outcomes of cardiac index (CI) and mixed venous oxygen saturation (SvO2) in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA). Methods In the cohort study of 789 patients included in the “BOX”-trial, 565 (77%) patients were included in this...
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Autor*in:	Grand, Johannes [verfasserIn] Hassager, Christian Schmidt, Henrik Mølstrøm, Simon Nyholm, Benjamin Høigaard, Henrik Frederiksen Dahl, Jordi S. Meyer, Martin Beske, Rasmus P. Obling, Laust Kjaergaard, Jesper Møller, Jacob E.

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Cardiac arrest Vasopressors Hemodynamic parameters Post-cardiac arrest syndrome

Anmerkung:	© The Author(s) 2023

Übergeordnetes Werk:	Enthalten in: Critical care - London : BioMed Central, 1997, 27(2023), 1 vom: 27. Okt.
Übergeordnetes Werk:	volume:27 ; year:2023 ; number:1 ; day:27 ; month:10

Links:	Volltext

DOI / URN:	10.1186/s13054-023-04704-2

Katalog-ID:	SPR053553020

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520			\|a Aim To assess the association with outcomes of cardiac index (CI) and mixed venous oxygen saturation (SvO2) in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA). Methods In the cohort study of 789 patients included in the “BOX”-trial, 565 (77%) patients were included in this hemodynamic substudy (age 62 ± 13 years, male sex 81%). Pulmonary artery catheters were inserted shortly after ICU admission. CI and SvO2 were measured as soon as possible in the ICU and until awakening or death. The endpoints were all-cause mortality at 1 year and renal failure defined as need for renal replacement therapy. Results First measured CI was median 1.7 (1.4–2.1) l/min/$ m^{2} $, and first measured SvO2 was median 67 (61–73) %. CI < median with SvO2 > median was present in 222 (39%), and low SvO2 with CI < median was present in 59 (11%). Spline analysis indicated that SvO2 value < 55% was associated with poor outcome. Low CI at admission was not significantly associated with mortality in multivariable analysis (p = 0.14). SvO2 was significantly inversely associated with mortality (hazard $ ratio_{adjusted} $: 0.91 (0.84–0.98) per 5% increase in SvO2, p = 0.01). SvO2 was significantly inversely associated with renal failure after adjusting for confounders ($ OR_{adjusted} $: 0.73 [0.62–0.86] per 5% increase in SvO2, p = 0.001). The combination of lower CI and lower SvO2 was associated with higher risk of mortality (hazard $ ratio_{adjusted} $: 1.54 (1.06–2.23) and renal failure ($ OR_{adjusted} $: 5.87 [2.34–14.73]. Conclusion First measured SvO2 after resuscitation from OHCA was inversely associated with mortality and renal failure. If SvO2 and CI were below median, the risk of poor outcomes increased significantly. Registration The BOX-trial is registered at clinicaltrials.gov (NCT03141099, date 2017–30–04, retrospectively registered). Graphical abstract
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700	1		\|a Beske, Rasmus P. \|4 aut
700	1		\|a Obling, Laust \|4 aut
700	1		\|a Kjaergaard, Jesper \|4 aut
700	1		\|a Møller, Jacob E. \|4 aut
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allfields	10.1186/s13054-023-04704-2 doi (DE-627)SPR053553020 (SPR)s13054-023-04704-2-e DE-627 ger DE-627 rakwb eng Grand, Johannes verfasserin (orcid)0000-0002-5511-4668 aut Serial assessments of cardiac output and mixed venous oxygen saturation in comatose patients after out-of-hospital cardiac arrest 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Aim To assess the association with outcomes of cardiac index (CI) and mixed venous oxygen saturation (SvO2) in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA). Methods In the cohort study of 789 patients included in the “BOX”-trial, 565 (77%) patients were included in this hemodynamic substudy (age 62 ± 13 years, male sex 81%). Pulmonary artery catheters were inserted shortly after ICU admission. CI and SvO2 were measured as soon as possible in the ICU and until awakening or death. The endpoints were all-cause mortality at 1 year and renal failure defined as need for renal replacement therapy. Results First measured CI was median 1.7 (1.4–2.1) l/min/$ m^{2} $, and first measured SvO2 was median 67 (61–73) %. CI < median with SvO2 > median was present in 222 (39%), and low SvO2 with CI < median was present in 59 (11%). Spline analysis indicated that SvO2 value < 55% was associated with poor outcome. Low CI at admission was not significantly associated with mortality in multivariable analysis (p = 0.14). SvO2 was significantly inversely associated with mortality (hazard $ ratio_{adjusted} $: 0.91 (0.84–0.98) per 5% increase in SvO2, p = 0.01). SvO2 was significantly inversely associated with renal failure after adjusting for confounders ($ OR_{adjusted} $: 0.73 [0.62–0.86] per 5% increase in SvO2, p = 0.001). The combination of lower CI and lower SvO2 was associated with higher risk of mortality (hazard $ ratio_{adjusted} $: 1.54 (1.06–2.23) and renal failure ($ OR_{adjusted} $: 5.87 [2.34–14.73]. Conclusion First measured SvO2 after resuscitation from OHCA was inversely associated with mortality and renal failure. If SvO2 and CI were below median, the risk of poor outcomes increased significantly. Registration The BOX-trial is registered at clinicaltrials.gov (NCT03141099, date 2017–30–04, retrospectively registered). Graphical abstract Cardiac arrest (dpeaa)DE-He213 Vasopressors (dpeaa)DE-He213 Hemodynamic parameters (dpeaa)DE-He213 Post-cardiac arrest syndrome (dpeaa)DE-He213 Hassager, Christian aut Schmidt, Henrik aut Mølstrøm, Simon aut Nyholm, Benjamin aut Høigaard, Henrik Frederiksen aut Dahl, Jordi S. aut Meyer, Martin aut Beske, Rasmus P. aut Obling, Laust aut Kjaergaard, Jesper aut Møller, Jacob E. aut Enthalten in Critical care London : BioMed Central, 1997 27(2023), 1 vom: 27. Okt. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:27 year:2023 number:1 day:27 month:10 https://dx.doi.org/10.1186/s13054-023-04704-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 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_4338 GBV_ILN_4367 GBV_ILN_4700 AR 27 2023 1 27 10
spelling	10.1186/s13054-023-04704-2 doi (DE-627)SPR053553020 (SPR)s13054-023-04704-2-e DE-627 ger DE-627 rakwb eng Grand, Johannes verfasserin (orcid)0000-0002-5511-4668 aut Serial assessments of cardiac output and mixed venous oxygen saturation in comatose patients after out-of-hospital cardiac arrest 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Aim To assess the association with outcomes of cardiac index (CI) and mixed venous oxygen saturation (SvO2) in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA). Methods In the cohort study of 789 patients included in the “BOX”-trial, 565 (77%) patients were included in this hemodynamic substudy (age 62 ± 13 years, male sex 81%). Pulmonary artery catheters were inserted shortly after ICU admission. CI and SvO2 were measured as soon as possible in the ICU and until awakening or death. The endpoints were all-cause mortality at 1 year and renal failure defined as need for renal replacement therapy. Results First measured CI was median 1.7 (1.4–2.1) l/min/$ m^{2} $, and first measured SvO2 was median 67 (61–73) %. CI < median with SvO2 > median was present in 222 (39%), and low SvO2 with CI < median was present in 59 (11%). Spline analysis indicated that SvO2 value < 55% was associated with poor outcome. Low CI at admission was not significantly associated with mortality in multivariable analysis (p = 0.14). SvO2 was significantly inversely associated with mortality (hazard $ ratio_{adjusted} $: 0.91 (0.84–0.98) per 5% increase in SvO2, p = 0.01). SvO2 was significantly inversely associated with renal failure after adjusting for confounders ($ OR_{adjusted} $: 0.73 [0.62–0.86] per 5% increase in SvO2, p = 0.001). The combination of lower CI and lower SvO2 was associated with higher risk of mortality (hazard $ ratio_{adjusted} $: 1.54 (1.06–2.23) and renal failure ($ OR_{adjusted} $: 5.87 [2.34–14.73]. Conclusion First measured SvO2 after resuscitation from OHCA was inversely associated with mortality and renal failure. If SvO2 and CI were below median, the risk of poor outcomes increased significantly. Registration The BOX-trial is registered at clinicaltrials.gov (NCT03141099, date 2017–30–04, retrospectively registered). Graphical abstract Cardiac arrest (dpeaa)DE-He213 Vasopressors (dpeaa)DE-He213 Hemodynamic parameters (dpeaa)DE-He213 Post-cardiac arrest syndrome (dpeaa)DE-He213 Hassager, Christian aut Schmidt, Henrik aut Mølstrøm, Simon aut Nyholm, Benjamin aut Høigaard, Henrik Frederiksen aut Dahl, Jordi S. aut Meyer, Martin aut Beske, Rasmus P. aut Obling, Laust aut Kjaergaard, Jesper aut Møller, Jacob E. aut Enthalten in Critical care London : BioMed Central, 1997 27(2023), 1 vom: 27. Okt. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:27 year:2023 number:1 day:27 month:10 https://dx.doi.org/10.1186/s13054-023-04704-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 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_4338 GBV_ILN_4367 GBV_ILN_4700 AR 27 2023 1 27 10
allfields_unstemmed	10.1186/s13054-023-04704-2 doi (DE-627)SPR053553020 (SPR)s13054-023-04704-2-e DE-627 ger DE-627 rakwb eng Grand, Johannes verfasserin (orcid)0000-0002-5511-4668 aut Serial assessments of cardiac output and mixed venous oxygen saturation in comatose patients after out-of-hospital cardiac arrest 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Aim To assess the association with outcomes of cardiac index (CI) and mixed venous oxygen saturation (SvO2) in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA). Methods In the cohort study of 789 patients included in the “BOX”-trial, 565 (77%) patients were included in this hemodynamic substudy (age 62 ± 13 years, male sex 81%). Pulmonary artery catheters were inserted shortly after ICU admission. CI and SvO2 were measured as soon as possible in the ICU and until awakening or death. The endpoints were all-cause mortality at 1 year and renal failure defined as need for renal replacement therapy. Results First measured CI was median 1.7 (1.4–2.1) l/min/$ m^{2} $, and first measured SvO2 was median 67 (61–73) %. CI < median with SvO2 > median was present in 222 (39%), and low SvO2 with CI < median was present in 59 (11%). Spline analysis indicated that SvO2 value < 55% was associated with poor outcome. Low CI at admission was not significantly associated with mortality in multivariable analysis (p = 0.14). SvO2 was significantly inversely associated with mortality (hazard $ ratio_{adjusted} $: 0.91 (0.84–0.98) per 5% increase in SvO2, p = 0.01). SvO2 was significantly inversely associated with renal failure after adjusting for confounders ($ OR_{adjusted} $: 0.73 [0.62–0.86] per 5% increase in SvO2, p = 0.001). The combination of lower CI and lower SvO2 was associated with higher risk of mortality (hazard $ ratio_{adjusted} $: 1.54 (1.06–2.23) and renal failure ($ OR_{adjusted} $: 5.87 [2.34–14.73]. Conclusion First measured SvO2 after resuscitation from OHCA was inversely associated with mortality and renal failure. If SvO2 and CI were below median, the risk of poor outcomes increased significantly. Registration The BOX-trial is registered at clinicaltrials.gov (NCT03141099, date 2017–30–04, retrospectively registered). Graphical abstract Cardiac arrest (dpeaa)DE-He213 Vasopressors (dpeaa)DE-He213 Hemodynamic parameters (dpeaa)DE-He213 Post-cardiac arrest syndrome (dpeaa)DE-He213 Hassager, Christian aut Schmidt, Henrik aut Mølstrøm, Simon aut Nyholm, Benjamin aut Høigaard, Henrik Frederiksen aut Dahl, Jordi S. aut Meyer, Martin aut Beske, Rasmus P. aut Obling, Laust aut Kjaergaard, Jesper aut Møller, Jacob E. aut Enthalten in Critical care London : BioMed Central, 1997 27(2023), 1 vom: 27. Okt. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:27 year:2023 number:1 day:27 month:10 https://dx.doi.org/10.1186/s13054-023-04704-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 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_4338 GBV_ILN_4367 GBV_ILN_4700 AR 27 2023 1 27 10
allfieldsGer	10.1186/s13054-023-04704-2 doi (DE-627)SPR053553020 (SPR)s13054-023-04704-2-e DE-627 ger DE-627 rakwb eng Grand, Johannes verfasserin (orcid)0000-0002-5511-4668 aut Serial assessments of cardiac output and mixed venous oxygen saturation in comatose patients after out-of-hospital cardiac arrest 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Aim To assess the association with outcomes of cardiac index (CI) and mixed venous oxygen saturation (SvO2) in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA). Methods In the cohort study of 789 patients included in the “BOX”-trial, 565 (77%) patients were included in this hemodynamic substudy (age 62 ± 13 years, male sex 81%). Pulmonary artery catheters were inserted shortly after ICU admission. CI and SvO2 were measured as soon as possible in the ICU and until awakening or death. The endpoints were all-cause mortality at 1 year and renal failure defined as need for renal replacement therapy. Results First measured CI was median 1.7 (1.4–2.1) l/min/$ m^{2} $, and first measured SvO2 was median 67 (61–73) %. CI < median with SvO2 > median was present in 222 (39%), and low SvO2 with CI < median was present in 59 (11%). Spline analysis indicated that SvO2 value < 55% was associated with poor outcome. Low CI at admission was not significantly associated with mortality in multivariable analysis (p = 0.14). SvO2 was significantly inversely associated with mortality (hazard $ ratio_{adjusted} $: 0.91 (0.84–0.98) per 5% increase in SvO2, p = 0.01). SvO2 was significantly inversely associated with renal failure after adjusting for confounders ($ OR_{adjusted} $: 0.73 [0.62–0.86] per 5% increase in SvO2, p = 0.001). The combination of lower CI and lower SvO2 was associated with higher risk of mortality (hazard $ ratio_{adjusted} $: 1.54 (1.06–2.23) and renal failure ($ OR_{adjusted} $: 5.87 [2.34–14.73]. Conclusion First measured SvO2 after resuscitation from OHCA was inversely associated with mortality and renal failure. If SvO2 and CI were below median, the risk of poor outcomes increased significantly. Registration The BOX-trial is registered at clinicaltrials.gov (NCT03141099, date 2017–30–04, retrospectively registered). Graphical abstract Cardiac arrest (dpeaa)DE-He213 Vasopressors (dpeaa)DE-He213 Hemodynamic parameters (dpeaa)DE-He213 Post-cardiac arrest syndrome (dpeaa)DE-He213 Hassager, Christian aut Schmidt, Henrik aut Mølstrøm, Simon aut Nyholm, Benjamin aut Høigaard, Henrik Frederiksen aut Dahl, Jordi S. aut Meyer, Martin aut Beske, Rasmus P. aut Obling, Laust aut Kjaergaard, Jesper aut Møller, Jacob E. aut Enthalten in Critical care London : BioMed Central, 1997 27(2023), 1 vom: 27. Okt. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:27 year:2023 number:1 day:27 month:10 https://dx.doi.org/10.1186/s13054-023-04704-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 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_4338 GBV_ILN_4367 GBV_ILN_4700 AR 27 2023 1 27 10
allfieldsSound	10.1186/s13054-023-04704-2 doi (DE-627)SPR053553020 (SPR)s13054-023-04704-2-e DE-627 ger DE-627 rakwb eng Grand, Johannes verfasserin (orcid)0000-0002-5511-4668 aut Serial assessments of cardiac output and mixed venous oxygen saturation in comatose patients after out-of-hospital cardiac arrest 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Aim To assess the association with outcomes of cardiac index (CI) and mixed venous oxygen saturation (SvO2) in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA). Methods In the cohort study of 789 patients included in the “BOX”-trial, 565 (77%) patients were included in this hemodynamic substudy (age 62 ± 13 years, male sex 81%). Pulmonary artery catheters were inserted shortly after ICU admission. CI and SvO2 were measured as soon as possible in the ICU and until awakening or death. The endpoints were all-cause mortality at 1 year and renal failure defined as need for renal replacement therapy. Results First measured CI was median 1.7 (1.4–2.1) l/min/$ m^{2} $, and first measured SvO2 was median 67 (61–73) %. CI < median with SvO2 > median was present in 222 (39%), and low SvO2 with CI < median was present in 59 (11%). Spline analysis indicated that SvO2 value < 55% was associated with poor outcome. Low CI at admission was not significantly associated with mortality in multivariable analysis (p = 0.14). SvO2 was significantly inversely associated with mortality (hazard $ ratio_{adjusted} $: 0.91 (0.84–0.98) per 5% increase in SvO2, p = 0.01). SvO2 was significantly inversely associated with renal failure after adjusting for confounders ($ OR_{adjusted} $: 0.73 [0.62–0.86] per 5% increase in SvO2, p = 0.001). The combination of lower CI and lower SvO2 was associated with higher risk of mortality (hazard $ ratio_{adjusted} $: 1.54 (1.06–2.23) and renal failure ($ OR_{adjusted} $: 5.87 [2.34–14.73]. Conclusion First measured SvO2 after resuscitation from OHCA was inversely associated with mortality and renal failure. If SvO2 and CI were below median, the risk of poor outcomes increased significantly. Registration The BOX-trial is registered at clinicaltrials.gov (NCT03141099, date 2017–30–04, retrospectively registered). Graphical abstract Cardiac arrest (dpeaa)DE-He213 Vasopressors (dpeaa)DE-He213 Hemodynamic parameters (dpeaa)DE-He213 Post-cardiac arrest syndrome (dpeaa)DE-He213 Hassager, Christian aut Schmidt, Henrik aut Mølstrøm, Simon aut Nyholm, Benjamin aut Høigaard, Henrik Frederiksen aut Dahl, Jordi S. aut Meyer, Martin aut Beske, Rasmus P. aut Obling, Laust aut Kjaergaard, Jesper aut Møller, Jacob E. aut Enthalten in Critical care London : BioMed Central, 1997 27(2023), 1 vom: 27. Okt. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:27 year:2023 number:1 day:27 month:10 https://dx.doi.org/10.1186/s13054-023-04704-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 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_4338 GBV_ILN_4367 GBV_ILN_4700 AR 27 2023 1 27 10
language	English
source	Enthalten in Critical care 27(2023), 1 vom: 27. Okt. volume:27 year:2023 number:1 day:27 month:10
sourceStr	Enthalten in Critical care 27(2023), 1 vom: 27. Okt. volume:27 year:2023 number:1 day:27 month:10
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Cardiac arrest Vasopressors Hemodynamic parameters Post-cardiac arrest syndrome
isfreeaccess_bool	true
container_title	Critical care
authorswithroles_txt_mv	Grand, Johannes @@aut@@ Hassager, Christian @@aut@@ Schmidt, Henrik @@aut@@ Mølstrøm, Simon @@aut@@ Nyholm, Benjamin @@aut@@ Høigaard, Henrik Frederiksen @@aut@@ Dahl, Jordi S. @@aut@@ Meyer, Martin @@aut@@ Beske, Rasmus P. @@aut@@ Obling, Laust @@aut@@ Kjaergaard, Jesper @@aut@@ Møller, Jacob E. @@aut@@
publishDateDaySort_date	2023-10-27T00:00:00Z
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Methods In the cohort study of 789 patients included in the “BOX”-trial, 565 (77%) patients were included in this hemodynamic substudy (age 62 ± 13 years, male sex 81%). Pulmonary artery catheters were inserted shortly after ICU admission. CI and SvO2 were measured as soon as possible in the ICU and until awakening or death. The endpoints were all-cause mortality at 1 year and renal failure defined as need for renal replacement therapy. Results First measured CI was median 1.7 (1.4–2.1) l/min/$ m^{2} $, and first measured SvO2 was median 67 (61–73) %. CI < median with SvO2 > median was present in 222 (39%), and low SvO2 with CI < median was present in 59 (11%). Spline analysis indicated that SvO2 value < 55% was associated with poor outcome. Low CI at admission was not significantly associated with mortality in multivariable analysis (p = 0.14). SvO2 was significantly inversely associated with mortality (hazard $ ratio_{adjusted} $: 0.91 (0.84–0.98) per 5% increase in SvO2, p = 0.01). 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topic_title	Serial assessments of cardiac output and mixed venous oxygen saturation in comatose patients after out-of-hospital cardiac arrest Cardiac arrest (dpeaa)DE-He213 Vasopressors (dpeaa)DE-He213 Hemodynamic parameters (dpeaa)DE-He213 Post-cardiac arrest syndrome (dpeaa)DE-He213
topic	misc Cardiac arrest misc Vasopressors misc Hemodynamic parameters misc Post-cardiac arrest syndrome
topic_unstemmed	misc Cardiac arrest misc Vasopressors misc Hemodynamic parameters misc Post-cardiac arrest syndrome
topic_browse	misc Cardiac arrest misc Vasopressors misc Hemodynamic parameters misc Post-cardiac arrest syndrome
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title	Serial assessments of cardiac output and mixed venous oxygen saturation in comatose patients after out-of-hospital cardiac arrest
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title_full	Serial assessments of cardiac output and mixed venous oxygen saturation in comatose patients after out-of-hospital cardiac arrest
author_sort	Grand, Johannes
journal	Critical care
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author_browse	Grand, Johannes Hassager, Christian Schmidt, Henrik Mølstrøm, Simon Nyholm, Benjamin Høigaard, Henrik Frederiksen Dahl, Jordi S. Meyer, Martin Beske, Rasmus P. Obling, Laust Kjaergaard, Jesper Møller, Jacob E.
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format_se	Elektronische Aufsätze
author-letter	Grand, Johannes
doi_str_mv	10.1186/s13054-023-04704-2
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title_sort	serial assessments of cardiac output and mixed venous oxygen saturation in comatose patients after out-of-hospital cardiac arrest
title_auth	Serial assessments of cardiac output and mixed venous oxygen saturation in comatose patients after out-of-hospital cardiac arrest
abstract	Aim To assess the association with outcomes of cardiac index (CI) and mixed venous oxygen saturation (SvO2) in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA). Methods In the cohort study of 789 patients included in the “BOX”-trial, 565 (77%) patients were included in this hemodynamic substudy (age 62 ± 13 years, male sex 81%). Pulmonary artery catheters were inserted shortly after ICU admission. CI and SvO2 were measured as soon as possible in the ICU and until awakening or death. The endpoints were all-cause mortality at 1 year and renal failure defined as need for renal replacement therapy. Results First measured CI was median 1.7 (1.4–2.1) l/min/$ m^{2} $, and first measured SvO2 was median 67 (61–73) %. CI < median with SvO2 > median was present in 222 (39%), and low SvO2 with CI < median was present in 59 (11%). Spline analysis indicated that SvO2 value < 55% was associated with poor outcome. Low CI at admission was not significantly associated with mortality in multivariable analysis (p = 0.14). SvO2 was significantly inversely associated with mortality (hazard $ ratio_{adjusted} $: 0.91 (0.84–0.98) per 5% increase in SvO2, p = 0.01). SvO2 was significantly inversely associated with renal failure after adjusting for confounders ($ OR_{adjusted} $: 0.73 [0.62–0.86] per 5% increase in SvO2, p = 0.001). The combination of lower CI and lower SvO2 was associated with higher risk of mortality (hazard $ ratio_{adjusted} $: 1.54 (1.06–2.23) and renal failure ($ OR_{adjusted} $: 5.87 [2.34–14.73]. Conclusion First measured SvO2 after resuscitation from OHCA was inversely associated with mortality and renal failure. If SvO2 and CI were below median, the risk of poor outcomes increased significantly. Registration The BOX-trial is registered at clinicaltrials.gov (NCT03141099, date 2017–30–04, retrospectively registered). Graphical abstract © The Author(s) 2023
abstractGer	Aim To assess the association with outcomes of cardiac index (CI) and mixed venous oxygen saturation (SvO2) in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA). Methods In the cohort study of 789 patients included in the “BOX”-trial, 565 (77%) patients were included in this hemodynamic substudy (age 62 ± 13 years, male sex 81%). Pulmonary artery catheters were inserted shortly after ICU admission. CI and SvO2 were measured as soon as possible in the ICU and until awakening or death. The endpoints were all-cause mortality at 1 year and renal failure defined as need for renal replacement therapy. Results First measured CI was median 1.7 (1.4–2.1) l/min/$ m^{2} $, and first measured SvO2 was median 67 (61–73) %. CI < median with SvO2 > median was present in 222 (39%), and low SvO2 with CI < median was present in 59 (11%). Spline analysis indicated that SvO2 value < 55% was associated with poor outcome. Low CI at admission was not significantly associated with mortality in multivariable analysis (p = 0.14). SvO2 was significantly inversely associated with mortality (hazard $ ratio_{adjusted} $: 0.91 (0.84–0.98) per 5% increase in SvO2, p = 0.01). SvO2 was significantly inversely associated with renal failure after adjusting for confounders ($ OR_{adjusted} $: 0.73 [0.62–0.86] per 5% increase in SvO2, p = 0.001). The combination of lower CI and lower SvO2 was associated with higher risk of mortality (hazard $ ratio_{adjusted} $: 1.54 (1.06–2.23) and renal failure ($ OR_{adjusted} $: 5.87 [2.34–14.73]. Conclusion First measured SvO2 after resuscitation from OHCA was inversely associated with mortality and renal failure. If SvO2 and CI were below median, the risk of poor outcomes increased significantly. Registration The BOX-trial is registered at clinicaltrials.gov (NCT03141099, date 2017–30–04, retrospectively registered). Graphical abstract © The Author(s) 2023
abstract_unstemmed	Aim To assess the association with outcomes of cardiac index (CI) and mixed venous oxygen saturation (SvO2) in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA). Methods In the cohort study of 789 patients included in the “BOX”-trial, 565 (77%) patients were included in this hemodynamic substudy (age 62 ± 13 years, male sex 81%). Pulmonary artery catheters were inserted shortly after ICU admission. CI and SvO2 were measured as soon as possible in the ICU and until awakening or death. The endpoints were all-cause mortality at 1 year and renal failure defined as need for renal replacement therapy. Results First measured CI was median 1.7 (1.4–2.1) l/min/$ m^{2} $, and first measured SvO2 was median 67 (61–73) %. CI < median with SvO2 > median was present in 222 (39%), and low SvO2 with CI < median was present in 59 (11%). Spline analysis indicated that SvO2 value < 55% was associated with poor outcome. Low CI at admission was not significantly associated with mortality in multivariable analysis (p = 0.14). SvO2 was significantly inversely associated with mortality (hazard $ ratio_{adjusted} $: 0.91 (0.84–0.98) per 5% increase in SvO2, p = 0.01). SvO2 was significantly inversely associated with renal failure after adjusting for confounders ($ OR_{adjusted} $: 0.73 [0.62–0.86] per 5% increase in SvO2, p = 0.001). The combination of lower CI and lower SvO2 was associated with higher risk of mortality (hazard $ ratio_{adjusted} $: 1.54 (1.06–2.23) and renal failure ($ OR_{adjusted} $: 5.87 [2.34–14.73]. Conclusion First measured SvO2 after resuscitation from OHCA was inversely associated with mortality and renal failure. If SvO2 and CI were below median, the risk of poor outcomes increased significantly. Registration The BOX-trial is registered at clinicaltrials.gov (NCT03141099, date 2017–30–04, retrospectively registered). Graphical abstract © The Author(s) 2023
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title_short	Serial assessments of cardiac output and mixed venous oxygen saturation in comatose patients after out-of-hospital cardiac arrest
url	https://dx.doi.org/10.1186/s13054-023-04704-2
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author2	Hassager, Christian Schmidt, Henrik Mølstrøm, Simon Nyholm, Benjamin Høigaard, Henrik Frederiksen Dahl, Jordi S. Meyer, Martin Beske, Rasmus P. Obling, Laust Kjaergaard, Jesper Møller, Jacob E.
author2Str	Hassager, Christian Schmidt, Henrik Mølstrøm, Simon Nyholm, Benjamin Høigaard, Henrik Frederiksen Dahl, Jordi S. Meyer, Martin Beske, Rasmus P. Obling, Laust Kjaergaard, Jesper Møller, Jacob E.
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up_date	2024-07-03T20:22:05.051Z
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