In comatose patients admitted to the hospital after being resuscitated from OHCA, a higher BP target was not beneficial, and a restrictive oxygenation target was not harmful, in the BOX randomized trial. ESCCongress
MAP is a good measure of organ perfusion pressure throughout the cardiac cycle, Kjaergaard, from Rigshospitalet, Copenhagen University Hospital, Denmark, explained.
"Therefore, we think our results support aiming for the lower blood pressure, even if the patients we studied had hypoxic brain injury," that is, they were comatose after the circulation had been restored."We think that the lower target should be implemented in protocols on treating comatose cardiac arrest patients.
"It is not a neutral study," Mebazaa, from Hôpital Lariboisière, Paris, said;"It is a positive trial for three reasons." Third,"in managing patients after cardiac arrest, the problem is not mortality, the problem is outcome," he said."Not only do we need to have those patients surviving, but they need to come back in the normal way with normal neurological conditions."Guidelines recommend a mean blood pressure target > 65 mm Hg in comatose patients who have been resuscitated after OHCA,"based on no data," Mebazaa commented.
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