ArticleIntensive care medicine2013
Higher mean arterial pressure with or without vasoactive agents is associated with increased survival and better neurological outcomes in comatose survivors of cardiac arrest.
Article in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it, 130 citations in OpenAlex.
- Determining Optimal Mean Arterial Pressure After Cardiac Arrest: A Systematic Review.Neurocritical care · 2021Pooled it
- Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation · 2015Guideline
- Effect of prehospital high-dose glucocorticoid on hemodynamics in patients resuscitated from out-of-hospital cardiac arrest: a sub-study of the STEROHCA trial.Critical care (London, England) · 2024Trial
- Targeting low-normal or high-normal mean arterial pressure after cardiac arrest and resuscitation: a randomised pilot trial.Intensive care medicine · 2018Trial
- Trial
- Why Post-Cardiac Arrest Interventions Often Fail: Therapeutic Amenability and the Rapidly Closing Window of Neuroprotection.Journal of clinical medicine · 2026Review
- Impact of hypotension burden on survival after in-hospital cardiac arrest: a retrospective observational study.BMC anesthesiology · 2026Observational
- Superior machine learning model for post-cardiac arrest mortality prediction: a MIMIC-IV cohort study.Resuscitation plus · 2026Article
- Association Between the Duration of Elevated Perfusion Pressure and Neurological Outcomes in Out-of-Hospital Cardiac Arrest Survivors.Reviews in cardiovascular medicine · 2025Article
- Journal Club Article: The STEROHCA trial - Optimizing post resuscitation haemodynamics by prehospital high dose corticosteroids.Resuscitation plus · 2025Article
- Implementing prehospital invasive arterial blood pressure monitoring in critically ill patients-a prospective observational first year analysis.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Observational
- Higher versus lower mean arterial blood pressure after cardiac arrest and resuscitation (MAP-CARE): A protocol for a randomized clinical trial.Acta anaesthesiologica Scandinavica · 2025Article
- Association among blood pressure, end-tidal carbon dioxide, peripheral oxygen saturation and mortality in prehospital post-resuscitation care.Resuscitation plus · 2024Article
- Review
- Survival, but not the severity of hypoxic-ischemic encephalopathy, is associated with higher mean arterial blood pressure after cardiac arrest: a retrospective cohort study.Frontiers in cardiovascular medicine · 2024Article
- Identification of post-cardiac arrest blood pressure thresholds associated with outcomes in children: an ICU-Resuscitation study.Critical care (London, England) · 2023Article
- Blood Pressure Targets for Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
- The effect of blood pressure on mortality following out-of-hospital cardiac arrest: a retrospective cohort study of the United Kingdom Intensive Care National Audit and Research Centre database.Critical care (London, England) · 2023Article
- Nicotinamide restores tissue NAD+ and improves survival in rodent models of cardiac arrest.PloS one · 2023Article
- Influence of circulatory shock at hospital admission on outcome after out-of-hospital cardiac arrest.Scientific reports · 2022Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe 2010 AHA Guidelines for Post-Cardiac Arrest Care recommend immediate treatment of hypotension to maintain adequate tissue perfusion with a goal of mean arterial pressure (MAP) of ≥65 mmHg. However, no studies exist examining the relationship between early hemodynamic goals and outcomes in post-cardiac arrest syndrome (PCAS) patients undergoing therapeutic hypothermia (TH). In this investigation, we examined the relationship between MAP, vasoactive agents, and survival or neurologic outcomes.
methodsConsecutive PCAS patients treated with algorithmic post-arrest care between 2005 and 2011 were included in this retrospective study. MAP and number of vasoactive agents were analyzed at 1, 6, 12, and 24 h after arrest. Primary outcome was survival at discharge. Data were analyzed using logistic regression analysis and ANOVA.
resultsOf 168 patients, 45% (75/168) survived, and 35% (58/168) had cerebral performance category (CPC) scores 1-2. Survivors had higher MAPs at 1 h (96 vs. 84 mmHg, p < 0.0001), 6 h (96 vs. 90 mmHg, p = 0.014), and 24 h (86 vs. 78 mmHg, p = 0.15) than non-survivors. Increased requirement for vasoactive agents was associated with mortality at all time points. Among those requiring vasoactive agents, survivors had higher MAPs than non-survivors at 1 h (97 vs. 82 mmHg, p = <0.0001) and 6 h (94 vs 87 mmHg, p = 0.05).
conclusionsHigher MAPs are associated with better outcomes in PCAS patients undergoing TH. Vasoactive agent requirement is associated with poor outcomes. Further prospective studies with specific MAP goals and hemodynamic optimization algorithms need to be performed.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.