Evidence map›Paper›PMID 40178107›Full record

ArticleActa anaesthesiologica Scandinavica2025

Continuous deep sedation versus minimal sedation after cardiac arrest and resuscitation (SED-CARE): A protocol for a randomized clinical trial.

A Ceric, J Dankiewicz, J Hästbacka, P Young, V H Niemelä, F Bass, M B Skrifvars, N Hammond, M Saxena, H Levin and 68 more

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Acta anaesthesiologica Scandinavica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07564778 (Characterizing and Quantifying Pain After Cardiac Arrest and Resuscitation), which is not on this map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

NCT07564778 recruitingnot on this map

Characterizing and Quantifying Pain After Cardiac Arrest and Resuscitation: Insights From the PAINCARE Substudy of the STEPCARE Trial

Typeobservational_patient_registrySponsorRegion SkaneRan2023 to 2028Enrolled300ConditionsPain, Out-of-hospital Cardiac Arrest (OHCA)
3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

78 authors.

A CericAnesthesia and Intensive Care, Department of Clinical Sciences, Lund University, Skane University Hospital, Malmö, Sweden.ORCID 0000-0001-6846-5961
J DankiewiczDepartment of Clinical Sciences Lund, Section of Cardiology, Skåne University Hospital, Malmö, Sweden.
J HästbackaFaculty of Medicine and Health Technology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa and Tampere University, Tampere, Finland.
P YoungIntensive Care Unit, Wellington Hospital, Wellington, New Zealand.
V H NiemeläDepartment of Anaesthesia and Intensive Care, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.ORCID 0009-0009-5048-4801
F BassThe George Institute for Global Health, Sydney, Australia.
M B SkrifvarsDepartment of Anaesthesia and Intensive Care, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.ORCID 0000-0002-0341-0262
N HammondCritical Care Program, The George Institute for Global Health, UNSW, Sydney, Australia.
M SaxenaCritical Care Division and Department of Intensive Care Medicine, The George Institute for Global Health and St George Hospital Clinical School, University of New South Wales, Sydney, Australia.
H LevinDepartment of Clinical Sciences Lund, Lund University, Lund, Sweden.
G LiljaNeurology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
M Moseby-KnappeDepartment of Clinical Sciences Lund, Lund University, Lund, Sweden.
M TiainenDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
M ReinikainenInstitute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
J HolgerssonDepartment of Clinical Sciences Lund, Anesthesia and Intensive Care, Lund University, Lund, Sweden.
C B KampCopenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
M P WiseAdult Critical Care, University Hospital of Wales, Cardiff, UK.
P J McGuiganWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK.
J WhiteAdult Critical Care, University Hospital of Wales, Cardiff, UK.ORCID 0000-0002-4557-3393
K SweetUniversity Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
T R KeebleEssex Cardiothoracic Centre, MSE NHSFT, Essex, UK.
G GloverDepartment of Critical Care, Guy's and St Thomas NHS Foundation Trust, London, UK.
P HopkinsFaculty of Life, Sciences and Medicine, King's College, Intensive Care Medicine, Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, London, UK.
C RemmingtonDepartment of Pharmacy and Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, UK.
J M ColeCritical Care, University Hospital of Wales, Cardiff, UK.
N GorgoraptisBartsHealth NHS Trust, London, UK.
D G PogsonDepartment of Critical Care, Portsmouth University Hospitals Trust, Portsmouth, UK.
P JacksonLeeds Teaching Hospitals NHS Trust, Leeds, UK.
J DüringDepartment of Clinical Sciences, Anesthesia and Intensive Care, Lund University, Skåne University Hospital, Malmö, Sweden.
A LybeckAnesthesia and Intensive Care, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden.ORCID 0000-0001-7574-3958
J JohnssonDepartment of Anaesthesiology and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden.
J UndenDepartment of Operation and Intensive Care, Hallands Hospital, Halmstad, Sweden.
A LundinDepartment of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0002-6623-6847
J KåhlinPerioperative Medicine and Intensive Care (PMI), Karolinska University Hospital, Stockholm, Sweden.
J GripFunction Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
E M LotmanNorth Estonia Medical Centre, Tallinn, Estonia.
L RomundstadDepartment of Anesthesia and Intensive Care medicine, Division of Emergencies and Critical care, Oslo University Hospital, Oslo, Norway.
P SeidelDepartment of Intensive Care Medicine, Stavanger University Hospital, Stavanger, Norway.
P StammetDepartment of Anaesthesia and Intensive Care Medicine, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg.
T GrafUniversity Heart Center Lübeck, University Hospital Schleswig-Holstein, Schleswig-Holstein, Germany.
A MengelDepartment of Neurology and Stroke, University Hospital Tuebingen, Hertie Institute of Clinical Brain Research, Tuebingen, Germany.
C LeithnerCharité-Universitätsmedizin Berlin, Department of Neurology, Freie Universität and Humboldt-Universität zu Berlin, Berlin, Germany.
J NeeDepartment of Nephrology and Medical Intensive Care, Charité-Universitaetsmedizin Berlin, Berlin, Germany.
P DruwéDepartment of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium.ORCID 0000-0001-8776-6591
K AmelootDepartment of Cardiology, Ziekenhuis Oost-, Genk, Limburg, Belgium.
A NicholUniversity College Dublin Clinical Research Centre at St Vincent's University Hospital, University College Dublin, Dublin, Ireland.
M HaenggiInstitute of Intensive Care Medicine University Hospital Zurich, Zurich, Switzerland.
M P HiltyInstitute of Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland.
M ItenDepartment of Intensive Care Medicine, Inselspital University Hospital Bern, Bern, Switzerland.ORCID 0000-0002-0140-2066
C SchragKlinik für Intensivmedizin, Kantonsspital St. Gallen, St. Gallen, Switzerland.
M NafiIstituto Cardiocentro Ticino, Lugano, Switzerland.ORCID 0000-0003-2733-9103
M JoannidisDivision of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Insbruck, Innsbruck, Austria.ORCID 0000-0002-6996-0881
C RobbaIRCCS Policlinico San Martino, Genova, Italy. Dipartimento di Scienze Chirurgiche Diagnostiche Integrate, University of Genova, Genova, Italy.
T PellisAnaesthesia and Intensive Care, Pordenone Hospital, Azienda Sanitaria Friuli Occidentale, Pordenone, Italy.
J BelohlavekFirst Faculty of Medicine, Charles University in Prague, Institute for Heart Diseases, Prauge, Czech Republic.
D RobSecond Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
Y M ArabiKing Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.ORCID 0000-0001-5735-6241
S BuabbasDepartment of Anestesia, Critical Care and Pain Medicine, Jaber Alahmad Alsabah Hospital, Kuwait City, Kuwait.
C Yew WoonTan Tock Seng Hospital, Singapore, Singapore.
A AnemanIntensive Care Unit, Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia.ORCID 0000-0003-2096-5304
A StewartLiverpool Hospital, Liverpool, Australia.
M ReadeMedical School, University of Queensland, Level 9, Health Sciences Building, Royal Brisbane and Women's Hospital, Brisbane, Australia.
C DelcourtThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.
A DelaneyCritical Care Program, The George Institute for Global Health. Malcolm Fisher Depratment of Intensive Care Medicine, Royal North Shore Hospital. Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.
M RamananCaboolture and Royal Brisbane and Women's Hospitals, Metro North Hospital and Health Service, Brisbane, Queensland, Australia.
B VenkateshThe George Institute for Global Health, Sydney, Australia.
L NavarraMedical Research Institute of New Zealand, Wellington, New Zealand.
B CrichtonMedical Research Institute of New Zealand, Wellington, New Zealand.
A WilliamsMiddlemore Hospital, Auckland, New Zealand.
D KnightDepartment of Intensive Care, Christchurch Hospital, Christchurch Central City, New Zealand.
J TirkkonenIntensive Care Unit, Tampere University Hospital, Tampere, Finland.
T OksanenDepartment of Anaesthesia and Intensive Care, Jorvi Hospital, University Hospital of Helsinki and University of Helsinki, Espoo, Finland.
T KaakinenResearch Unit of Translational Medicine, Research Group of Anaesthesiology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
S BendelInstitute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
H FribergAnesthesia and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
T CronbergNeurology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
J C JakobsenCopenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
N NielsenDepartment of Clinical Sciences Lund, Anesthesia and Intensive Care, Lund University, Lund, Sweden.

Funding

ALF-project funding within the Swedish Health CareClinical Research Programme Directorate of Health Ministry of Health and Social Security (Luxembourg)Health Research Council of New ZealandHospital district of Helsinki and Uusimaa (Finland)Medical Research Future Fund (199449)Medical Research Future Fund (Australia)Medicinska Understödsföreningen Liv och HälsaSigrid Juséliuksen Säätiö (8137)The Academy of Finland (341277)The Sigrid Jusélius Foundation (Finland) (8137)Vetenskapsrådet
6 · The paper itself

Abstract

backgroundSedation is often provided to resuscitated out-of-hospital cardiac arrest (OHCA) patients to tolerate post-cardiac arrest care, including temperature management. However, the evidence of benefit or harm from routinely administered deep sedation after cardiac arrest is limited. The aim of this trial is to investigate the effects of continuous deep sedation compared to minimal sedation on patient-important outcomes in resuscitated OHCA patients in a large clinical trial.

methodsThe SED-CARE trial is part of the 2 × 2 × 2 factorial Sedation, Temperature and Pressure after Cardiac Arrest and Resuscitation (STEPCARE) trial, a randomized international, multicentre, parallel-group, investigator-initiated, superiority trial with three simultaneous intervention arms. In the SED-CARE trial, adults with sustained return of spontaneous circulation (ROSC) who are comatose following resuscitation from OHCA will be randomized within 4 hours to continuous deep sedation (Richmond agitation and sedation scale (RASS) -4/-5) (intervention) or minimal sedation (RASS 0 to -2) (comparator), for 36 h after ROSC. The primary outcome will be all-cause mortality at 6 months after randomization. The two other components of the STEPCARE trial evaluate sedation and temperature control strategies. Apart from the STEPCARE trial interventions, all other aspects of general intensive care will be according to the local practices of the participating site. Neurological prognostication will be performed according to European Resuscitation Council and European Society of Intensive Care Medicine guidelines by a physician blinded to the allocation group. To detect an absolute risk reduction of 5.6% with an alpha of 0.05, 90% power, 3500 participants will be enrolled. The secondary outcomes will be the proportion of participants with poor functional outcomes 6 months after randomization, serious adverse events in the intensive care unit, and patient-reported overall health status 6 months after randomization.

conclusionThe SED-CARE trial will investigate if continuous deep sedation (RASS -4/-5) for 36 h confers a mortality benefit compared to minimal sedation (RASS 0 to -2) after cardiac arrest.

Indexed as

Cardiopulmonary ResuscitationDeep SedationOut-of-Hospital Cardiac ArrestProcedural SedationAdultEquivalence Trials as TopicHumansRandomized Controlled Trials as Topiccardiac arrestrandomized clinical trialsedation

Identifiers

PMID40178107
PMCPMC11967157

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Registered trials

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