Early Higher Achieved Mean Arterial Pressure Is Not Associated with Clinical Outcomes after Cardiac Arrest: A systematic Review and Meta-analysis

Abstract

Purpose: This study investigated the effect of early higher achieved mean arterial pressure (MAP) on clinical outcomes after cardiac arrest (CA).Methods: PubMed, ScienceDirect, Web of Science, China National Knowledge Infrastructure, and Wanfang databases were searched for relevant articles until May 2020. The meta-analysis produced pooled effect size represented by odds ratios (ORs) and corresponding 95% confidence intervals (CIs).Results: Nine studies that enrolled 1337 participants were considered eligible for this meta-analysis. Early higher achieved MAP was associated with similar mortality (OR 0.54, 95% CI 0.26 – 1.12; p = 0.10), neurologic outcome (OR 1.30, 95% CI 0.65 – 2.58; p = 0.46), length of ICU stay (OR -0.06, 95% CI -0.31 – 0.19; p = 0.46), mechanical ventilation time (OR -0.14, 95% CI -0.90 – 0.62; p = 0.72), and bleeding (OR 0.57, 95% CI 0.23 – 1.40; p = 0.22) compared with low MAP. Sensitivity analysis demonstrated that the result was solid. No publication bias across the studies was observed using Begg's and Egger’ funnel plot plot. Conclusion: Based on current evidence, this meta-analysis confirmed that early higher achieved MAP does not improve the clinical outcomes after CA.REGISTRATION: (PROSPERO: CRD42020189875)