Acute cardiac care & resuscitationSecondary analysis
Blood Pressure and Oxygen Targets on Kidney Injury After Cardiac Arrest
- Secondary analysis of a randomised 2-by-2 factorial trial
- substudy
Authors' conclusion
In comatose patients who had been resuscitated after out-of-hospital cardiac arrest, patients allocated to a combination of a low mean arterial blood pressure and a liberal oxygen target had a significantly increased risk of mild-stage AKI. No difference was found in terms of more severe AKI stages or other kidney-related adverse outcomes, and creatinine had normalized at 1 year after discharge.
Study context
- Population
- Comatose adults resuscitated after OHCA of presumed cardiac cause with sustained return of spontaneous circulation759 survived ≥48 h
- Participants
- 789 adults
- Comparison
- Low vs high MAP target and restrictive vs liberal oxygen target after OHCA
- high blood pressure and liberal oxygen targetn = 187reference
- low blood pressure and liberal oxygen targetn = 193
- Primary endpoint
- AKI by KDIGO classification in patients surviving ≥48 hours
Primary result
AKI (KDIGO) in patients surviving ≥48 hours
Adjusted odds ratio
1.87
95% CI 1.21–2.89
Events by treatment group
low blood pressure and liberal oxygen target vs high blood pressure and liberal oxygen target
adjusted OR 1.87 (95% CI 1.21–2.89)
As reported in the abstract
Further findings
Plasma creatinine · 6 and 12 months
- Remained high during hospitalization with low BP + liberal oxygen; no difference between groups at 6- and 12-month follow-up
Original publication
Blood Pressure and Oxygen Targets on Kidney Injury After Cardiac Arrest. Circulation. Published 4 October 2023. doi:10.1161/circulationaha.123.066012
Summarised from the published abstract; every number is checked against it