Mean Arterial Pressure After Out-of-hospital Cardiac Arrest: the METAPHORE Randomized Trial

What this Trial Is About

Out-of-hospital cardiac arrest is a serious health issue with survival rates below 10%. The main cause of death in intensive care units after such an event is post-cardiac arrest syndrome, which leads to shock or brain injury due to lack of oxygen. Brain injury may worsen if blood flow is not properly maintained in the first hours after the heart starts beating again. This research aims to compare two blood pressure targets to see if higher blood pressure after cardiac arrest improves brain function recovery. Participants will be randomly assigned to one of two groups. One group will receive treatment to keep their mean arterial pressure (MAP) at or above 90 mmHg for 24 hours using norepinephrine. The other group will have a standard target MAP of at least 65 mmHg for 24 hours with the same medication. After the initial 24 hours, both groups will aim for MAP of 65 mmHg until they leave the ICU. During the study, patients will be monitored for brain function and survival for up to 180 days. Researchers will evaluate neurological outcomes, survival rates at various points, quality of life, frailty, and kidney function. The study includes measurement of days without ICU stay, ventilator, or kidney therapy. Safety and long-term outcomes will be assessed to understand the effects of different blood pressure targets after cardiac arrest.

Mean Arterial Pressure After Out-of-hospital Cardiac Arrest