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Table 1 Pooled results (from [3] and [4]) on early post-enrollment hemodynamics in survivors for ≥4 h with post-resuscitation shock

From: Possible significance of hemodynamic and immunomodulatory effects of early stress-dose steroids in cardiac arrest

Survivors for ≥4 h with post-resuscitation shocka VSE group (n = 103) Control group (n = 88) P value
Time to discontinuation of vasopressors (days), median (IQR)b 4 (2–8) 3 (2–6) 0.86
Discontinuation of vasopressors during follow-up, n (%) 43 (41.7) 34 (38.6) 0.77
Estimated cumulative vasopressor dose (μg/kg) over the first 24 h post-ROSC, median (IQR)c,d,e 552 (216–1225) 629 (321–1236) (n = 87) 0.15
Cumulative 24-h post-ROSC fluid balance (mL), mean ± SD 2168 ± 2398 (n = 78) 2034 ± 2198 (n = 60) 0.74
SAP >90 mmHg within 15–20 min post-ROSC, n (%) 76 (80.9) (n = 94) 40 (55.6) (n = 72) 0.001
At least 1 recorded/analyzed MAP value >80 mmHg over day 1, n (%) 82 (80.4) (n = 102) 35 (42.2) (n = 83) <0.001
ALS duration (min), median (IQR) 10 (6–16) 12 (6–20) 0.11
  SAP >90 mmHg (n = 116) SAP ≤90 mmHg (n = 50) P value
Survival to hospital discharge with CPC score of 1 or 2, n (%) 23 (19.8) 3 (6.0) 0.02
  MAP >80 mmHg (n = 117) MAP ≤80 mmHg (n = 68) P value
Survival to hospital discharge with CPC score of 1 or 2, n (%) 25 (21.4) 4 (5.9) 0.006
  1. Data reported as n (%) were analyzed with the Fisher’s exact test; data reported as median (IQR) were analyzed with the Mann-Whitney exact U test; and data reported as mean ± SD were analyzed with the independent samples t test
  2. aDefined as sustained (>4 h), new post-arrest circulatory failure or post-arrest need for ≥50 % increase in any pre-arrest vasopressor/inotropic support targeted to MAP >70 mmHg [3, 4]
  3. bDefined as number of days from study enrollment until the first circulatory failure-free day; the latter corresponds to a sequential organ failure assessment (SOFA) circulatory subscore <3; in both studies [3, 4], the SOFA score was determined daily through follow-up days 1–60 post-randomization
  4. cWith respect to [3]: average daily infusion rates (IRs) of vasopressors were already available as they were calculated by the investigators who conducted the follow-up; corresponding results were reported in the supplement of the originally published article. Consequently, Day 1 dose of a vasopressor (VD) (μg/kg) = average daily IR (μg/kg/min) × 1440 (min)
  5. dWith respect to [4]: for patients with IR data (μg/kg/min) available at 20 min post-ROSC (IR20M), 4 h post-ROSC (IR4H), and 24 h post-ROSC (IR24H) (n = 108), VD (μg/kg) was estimated as follows: VD = average (IR20M; IR4H) × 240 (min) + average (IR4H; IR24H) × 1200 (min). For patients with available IR20M and IR4H (n = 39), VD (μg/kg) was estimated as follows: VD = average (IR20M; IR4H) × 240 (min) + IR4H × (number of min until death after the completion of 4-h survival). For patients with available IR20M only (n = 1), VD (μg/kg) was estimated as follows: VD = IR20M × (number of min until death)
  6. eFor both [3] and [4], total day 1 VD (μg/kg) was calculated as follows [1]: VD = norepinephrine (μg/kg) + dopamine/2 (μg/kg) + epinephrine (μg/kg)
  7. ALS advanced life support, CPC cerebral performance category, IQR interquartile range, MAP mean arterial pressure, ROSC return of spontaneous circulation, SAP systolic arterial pressure, SD standard deviation, VSE vasopressin-steroids-epinephrine
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Critical Care

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