The optimal peripheral oxygen saturation may be 95–97% for post-cardiac arrest patients: A retrospective observational study

Zhou, Dawei; Li, Z.M.; Zhang, S.L.; Wu, Lei; Li, Yifeng; Zhou, Jianxin; Shi, Guangzhi

doi:10.1016/j.ajem.2020.01.038

Cited by 3 publications

(1 citation statement)

References 43 publications

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“…[23][24][25] A retrospective study suggested 95%-97% SpO 2 to be the optimal target oxygen saturation after cardiac arrest. 26 These studies were, however, limited by bias because of their observational nature. One of the initial randomized controlled trials by Kuisma et al 8 showed no significant difference in mortality between 30% and 100% oxygen supplementation in the postresuscitation period, but the latter group had increased concentrations of neuron-specific enolase (NSE) level, a marker of neurological injury.…”

Section: Discussionmentioning

confidence: 99%

Oxygen Targets After Cardiac Arrest: A Meta-analysis of Randomized Controlled Trials

Singh,

Rout,

Chaudhary

et al. 2023

American Journal of Therapeutics

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Background: Optimal oxygen saturation target in patients resuscitated after cardiac arrest is unknown. Previous randomized controlled trials (RCTs) comparing restrictive oxygen therapy with liberal therapy have shown conflicting results. Study Question: We performed a meta-analysis of available RCTs to consolidate the contrasting findings regarding the oxygen targets after cardiac arrest. Data Sources: We searched electronic databases for RCTs comparing restrictive versus liberal oxygen targets in patients resuscitated after cardiac arrest. Study Design: End points of interest were mortality, unfavorable neurological outcomes, and rearrests. Random-effects meta-analysis was performed to estimate the risk ratio (RR) with a 95% confidence interval (CI). Results: Eight RCTs with 1641 patients (restrictive n = 833, liberal n = 808) were included in the analysis. The oxygen targets were defined by either saturation, partial pressure (PaO2), or supplementation rates. The mean age and male percentage were 63 years and 80%, respectively. There was no significant difference observed in the 2 groups for overall mortality (RR = 0.91, 95% CI = 0.75–1.10, P = 0.33), unfavorable neurological outcomes (RR = 0.93, 95% CI = 0.74–1.18, P = 0.56), and rearrests (RR = 0.67, 95% CI = 0.22–1.98, P = 0.47). Conclusions: Overall, this meta-analysis shows no significant difference in mortality, unfavorable neurological outcomes, and rearrests when using restrictive or liberal oxygen targets in patients after cardiac arrest. The limitations in the newer trials should be kept in mind while interpreting the overall results.

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