No Benefit to Higher or Lower Blood Pressure and Oxygen Targets in Comatose Patients After Cardiac Arrest

Oxygen delivery to the brain is essential after cardiac arrest. Inadequate perfusion worsens ischemic injury; however, animal models suggest that hyperoxia also can be harmful. Evidence is limited for blood pressure and oxygenation goals for patients who are comatose after cardiac arrest; two recent large trials showed no benefit for conservative oxygenation (NEJM JW Gen Med Mar 1 2021 and N Engl J Med 2021; 384:1301; NEJM JW Gen Med Dec 15 2019 and N Engl J Med 2020; 382:989).

Danish investigators randomized nearly 800 comatose survivors of out-of-hospital cardiac arrest to a mean arterial pressure (MAP) target of 63 mm Hg or 77 mm Hg during their intensive care unit stay and also, in a 2×2 factorial design, to a restrictive or liberal oxyg…