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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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