Randomised controlled trial
Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest
- Randomised controlled trial
- multicentre
Authors' conclusion
In patients with coma who were resuscitated after out-of-hospital cardiac arrest, targeted mild hypercapnia did not lead to better neurologic outcomes at 6 months than targeted normocapnia.
Study context
- Population
- Comatose adults resuscitated after OHCA of presumed cardiac or unknown cause, admitted to the intensive care unit (ICU)63 ICUs in 17 countries
- Participants
- 1,700 adults
- Comparison
- Targeted mild hypercapnia vs targeted normocapnia for 24 hours
- Mild hypercapnian = 847
- Normocapnian = 853reference
- Primary endpoint
- Favorable neurologic outcome (Glasgow Outcome Scale-Extended score ≥5)
- Follow-up
- 6 months
Primary result
Favorable neurologic outcome
Relative risk
0.98
95% CI 0.87–1.11
P = 0.76
Events by treatment group
Mild hypercapnia vs Normocapnia
RR 0.98 (95% CI 0.87–1.11); P = 0.76
As reported in the abstract
Secondary outcomes
| Outcome | Mild hypercapnia | Normocapnia | RR (95% CI) | |
|---|---|---|---|---|
| Death within 6 months | 48.2% | 45.9% | 1.05 (0.94–1.16) | |
| 0.512Relative risk (log scale) |
- Death within 6 months: 393 of 816 vs 382 of 832
Safety
Adverse events
- Incidence did not differ significantly between groups
Original publication
Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest. N Engl J Med. Published 15 June 2023. doi:10.1056/nejmoa2214552
Summarised from the published abstract; every number is checked against it