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Resuscitation. 2014 Dec;85(12):1686-91. doi: 10.1016/j.resuscitation.2014.09.011. Epub 2014 Sep 28.

HyperOxic Therapy OR NormOxic Therapy after out-of-hospital cardiac arrest (HOT OR NOT): a randomised controlled feasibility trial.

Author information

1
Medical Research Institute of New Zealand, PO Box 7902, Wellington, New Zealand; Wellington Hospital, Capital and Coast District Health Board, Private Bag 7902, Wellington, New Zealand. Electronic address: paul.young@ccdhb.org.nz.
2
Wellington Free Ambulance, PO Box 601, Wellington, New Zealand.
3
Intensive Care Unit, Austin Hospital, PO Box 5555, Heidelberg, 3084 Victoria, Australia; Australian and New Zealand Intensive Care Research Centre, The Alfred Centre, Level 6 (Lobby B), 99 Commercial Road, Melbourne, 3004 Victoria, Australia.
4
Alfred Hospital, 55 Commercial Road, Melbourne, 3004 Victoria, Australia.
5
St John Ambulance, 2 Harrison Road, Private Bag 14902, Panmure, Auckland, New Zealand.
6
Medical Research Institute of New Zealand, PO Box 7902, Wellington, New Zealand; Hawke's Bay Hospital, Omahu Road, Private Bag 9014, Hastings, New Zealand; Chinese University of Hong Kong, Sha Tin, Hong Kong, China.
7
Medical Research Institute of New Zealand, PO Box 7902, Wellington, New Zealand; Christchurch Hospital, 2 Riccarton Avenue, Christchurch, New Zealand.
8
Medical Research Institute of New Zealand, PO Box 7902, Wellington, New Zealand; Wellington Hospital, Capital and Coast District Health Board, Private Bag 7902, Wellington, New Zealand.
9
Medical Research Institute of New Zealand, PO Box 7902, Wellington, New Zealand; Australian and New Zealand Intensive Care Research Centre, The Alfred Centre, Level 6 (Lobby B), 99 Commercial Road, Melbourne, 3004 Victoria, Australia; Auckland City Hospital, 2 Park Road, Grafton, Auckland, New Zealand.
10
St John Ambulance, 2 Harrison Road, Private Bag 14902, Panmure, Auckland, New Zealand; Auckland City Hospital, 2 Park Road, Grafton, Auckland, New Zealand.
11
Wellington Hospital, Capital and Coast District Health Board, Private Bag 7902, Wellington, New Zealand; Wellington Free Ambulance, PO Box 601, Wellington, New Zealand.
12
Medical Research Institute of New Zealand, PO Box 7902, Wellington, New Zealand; Wellington Hospital, Capital and Coast District Health Board, Private Bag 7902, Wellington, New Zealand; University of Otago, School of Medicine, PO Box 7343, Wellington South, Wellington, New Zealand.

Abstract

AIMS:

To investigate the feasibility of delivering titrated oxygen therapy to adults with return of spontaneous circulation (ROSC) following out-of-hospital cardiac arrest (OHCA) caused by ventricular fibrillation (VF) or ventricular tachycardia (VT).

METHODS:

We used a multicentre, randomised, single blind, parallel groups design to compare titrated and standard oxygen therapy in adults resuscitated from VF/VT OHCA. The intervention commenced in the community following ROSC and was maintained in the emergency department and the Intensive Care Unit. The primary end point was the median oxygen saturation by pulse oximetry (SpO2) in the pre-hospital period.

RESULTS:

159 OHCA patients were screened and 18 were randomised. 17 participants were analysed: nine in the standard care group and eight in the titrated oxygen group. In the pre-hospital period, SpO2 measurements were lower in the titrated oxygen therapy group than the standard care group (difference in medians 11.3%; 95% CI 1.0-20.5%). Low measured oxygen saturation (SpO2<88%) occurred in 7/8 of patients in the titrated oxygen group and 3/9 of patients in the standard care group (P=0.05). Following hospital admission, good separation of oxygen exposure between the groups was achieved without a significant increase in hypoxia events. The trial was terminated because accumulated data led the Data Safety Monitoring Board and Management Committee to conclude that safe delivery of titrated oxygen therapy in the pre-hospital period was not feasible.

CONCLUSIONS:

Titration of oxygen in the pre-hospital period following OHCA was not feasible; it may be feasible to titrate oxygen safely after arrival in hospital.

KEYWORDS:

Cardiac arrest; Hyperoxia; Oxygen therapy

[Indexed for MEDLINE]

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