Lower versus higher oxygen targets after resuscitation from out-of-hospital cardiac arrest: A systematic review and meta-analysis of randomized controlled trials

Link to article at PubMed

J Crit Care. 2023 Oct 18;79:154448. doi: 10.1016/j.jcrc.2023.154448. Online ahead of print.

ABSTRACT

PURPOSE: To update the existing evidence and gain further insight into effects of lower versus higher oxygen targets on the outcomes in patients resuscitated from out-of-hospital cardiac arrest (OHCA).

METHODS: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing lower versus higher oxygen targets on the outcomes among adults resuscitated from OHCA. The primary outcome was short-term survival (in hospital or within 30 days). Subgroup analyses were performed according to timing of study interventions.

RESULTS: Seven RCTs with 1454 patients were finally included. The short-term survival did not differ between the two groups with a relative risk (RR) of 0.98 (95% CI, 0.86 to 1.11). There were no significant differences in survival at longest follow-up (RR, 1.01; 95% CI, 0.91 to 1.14), favorable neurological outcome (RR, 1.00; 95% CI, 0.91 to 1.11), length of intensive care unit stay (mean difference, -4.94 h; 95% CI, -14.83 to 4.96 h), or risk of re-arrest (RR, 0.68; 95% CI, 0.21 to 2.19). The quality of evidence ranged from moderate to very low.

CONCLUSION: Current evidence suggests that targeting a lower or higher oxygen therapy in patients after resuscitation from OHCA results in similar short-term survival and other clinical outcomes.

PMID:37862956 | DOI:10.1016/j.jcrc.2023.154448

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