Acute cardiac care & resuscitation
Effect of oxygen targets on pulmonary hemodynamics after out-of-hospital cardiac arrest – A sub-study of the BOX cardiac arrest trial
Primary result · PVRResult — go to the resultMean difference 0.05 WU 95% CI −0.09 to 0.18Authors' conclusion
Pulmonary hypertension is an independent risk factor for mortality in comatose resuscitated patients after OHCA. However, a restrictive oxygen strategy aiming at a PaO2 of 9-10 kPa during post-resuscitation critical care was not associated with a higher PVR or deterioration of right ventricular function compared to a liberal oxygen strategy.
Study context
- Population
- Comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA) with right heart catheterizationof 789 randomized
- Participants
- 730 patients
- Comparison
- Restrictive vs liberal oxygen target
- Primary endpoint
- Difference in pulmonary vascular resistance (PVR) between oxygen groups (linear mixed models for repeated measures)
- Follow-up
- Within 48 h
Methodological detailspredefined sub-study, two-centre, prospective, double-blinded
- Predefined sub-study
- Two-centre
- Prospective
- Double-blinded
Primary result
PVR
Mean difference
0.05 WU
95% CI −0.09 to 0.18
P = 0.50
Liberal vs Restrictive
mean difference 0.05 WU (95% CI −0.09 to 0.18); P = 0.50
As reported in the abstract
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| One-year mortality by mPAP · adjusted | 4.2 (2.0–9.2) | P < 0.001 | |
| 0.10.31310Odds ratio (log scale) |
Haemodynamics at admission (all patients)
- Median pulmonary vascular resistance (PVR)
- 2.4 wood unit (WU) (95% CI, 1.7-3.4)
- Median mean pulmonary artery pressure (mPAP)
- 25 mmHg (95% CI, 21-30)
- Median pulmonary artery pulsatility index (PAPi)
- 1.3 (95% CI, 0.8-1.8)
mPAP, PAPi and right atrial pressure
- Did not differ between groups
- P > 0.05
One-year mortality by mPAP
- Adjusted odds of one-year mortality increased progressively and linearly over a wide mPAP range
Original publication
Effect of oxygen targets on pulmonary hemodynamics after out-of-hospital cardiac arrest – A sub-study of the BOX cardiac arrest trial. Resuscitation. Published 13 June 2025. doi:10.
Summarised from the published abstract; every number is checked against it