Conservative or liberal oxygen therapy in adults after cardiac arrest
dc.contributor.author | Young, PJ | |
dc.contributor.author | Bailey, M | |
dc.contributor.author | Bellomo, R | |
dc.contributor.author | Bernard, S | |
dc.contributor.author | Bray, J | |
dc.contributor.author | Jakkula, P | |
dc.contributor.author | Kuisma, M | |
dc.contributor.author | Mackle, D | |
dc.contributor.author | Martin, Daniel | |
dc.contributor.author | Nolan, JP | |
dc.contributor.author | Panwar, R | |
dc.contributor.author | Reinikainen, M | |
dc.contributor.author | Skrifvars, MB | |
dc.contributor.author | Thomas, M | |
dc.date.accessioned | 2020-11-02T17:41:56Z | |
dc.date.issued | 2020-10-12 | |
dc.identifier.issn | 0300-9572 | |
dc.identifier.issn | 1873-1570 | |
dc.identifier.uri | http://hdl.handle.net/10026.1/16619 | |
dc.description.abstract |
AIM: The effect of conservative versus liberal oxygen therapy on mortality rates in post cardiac arrest patients is uncertain. METHODS: We undertook an individual patient data meta-analysis of patients randomised in clinical trials to conservative or liberal oxygen therapy after a cardiac arrest. The primary end point was mortality at last follow-up. RESULTS: Individual level patient data were obtained from seven randomised clinical trials with a total of 429 trial participants included. Four trials enrolled patients in the pre-hospital period. Of these, two provided protocol-directed oxygen therapy for 60 min, one provided it until the patient was handed over to the emergency department staff, and one provided it for a total of 72 h or until the patient was extubated. Three trials enrolled patients after intensive care unit (ICU) admission and generally continued protocolised oxygen therapy for a longer period, often until ICU discharge. A total of 90 of 221 patients (40.7%) assigned to conservative oxygen therapy and 103 of 206 patients (50%) assigned to liberal oxygen therapy had died by this last point of follow-up; absolute difference; odds ratio (OR) adjusted for study only; 0.67; 95% CI 0.45 to 0.99; P = 0.045; adjusted OR, 0.58; 95% CI 0.35 to 0.96; P = 0.04. CONCLUSION: Conservative oxygen therapy was associated with a statistically significant reduction in mortality at last follow-up compared to liberal oxygen therapy but the certainty of available evidence was low or very low due to bias, imprecision, and indirectness. PROSPERO REGISTRATION NUMBER: CRD42019138931. | |
dc.format.extent | 15-22 | |
dc.format.medium | Print-Electronic | |
dc.language | en | |
dc.language.iso | en | |
dc.publisher | Elsevier BV | |
dc.subject | Oxygen therapy | |
dc.subject | Cardiac arrest | |
dc.subject | Hypoxic ischaemic encephalopathy | |
dc.subject | Hyperoxaemia | |
dc.subject | Hypoxaemia | |
dc.subject | Randomised controlled trial | |
dc.subject | Individual patient data meta-analysis | |
dc.title | Conservative or liberal oxygen therapy in adults after cardiac arrest | |
dc.type | journal-article | |
dc.type | Journal Article | |
dc.type | Meta-Analysis | |
dc.type | Research Support, Non-U.S. Gov't | |
plymouth.author-url | https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000603700700010&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008 | |
plymouth.volume | 157 | |
plymouth.publication-status | Published | |
plymouth.journal | Resuscitation | |
dc.identifier.doi | 10.1016/j.resuscitation.2020.09.036 | |
plymouth.organisational-group | /Plymouth | |
plymouth.organisational-group | /Plymouth/Faculty of Health | |
plymouth.organisational-group | /Plymouth/Faculty of Health/Peninsula Medical School | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine | |
plymouth.organisational-group | /Plymouth/Users by role | |
plymouth.organisational-group | /Plymouth/Users by role/Academics | |
dc.publisher.place | Ireland | |
dcterms.dateAccepted | 2020-09-30 | |
dc.rights.embargodate | 2021-10-12 | |
dc.identifier.eissn | 1873-1570 | |
dc.rights.embargoperiod | Not known | |
rioxxterms.versionofrecord | 10.1016/j.resuscitation.2020.09.036 | |
rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.licenseref.startdate | 2020-10-12 | |
rioxxterms.type | Journal Article/Review |