Author, as appears in the article.: Azeli Y; Bardají A; Barbería E; Lopez-Madrid V; Bladé-Creixenti J; Fernández-Sender L; Bonet G; Rica E; Álvarez S; Fernández A; Axelsson C; Jiménez-Herrera MF

Department: Enginyeria Química Infermeria Medicina i Cirurgia Ciències Mèdiques Bàsiques

URV's Author/s: Alvarez Fernandez, Susana Maria / Barberia Marcalain, Eneko / Fernández Sabater, Alberto / Jiménez Herrera, María Francisca

Keywords: Tidal carbon-dioxide Survival Porcine model Perfusion pressures Performance Passive leg raising Out-of-hospital cardiac arrest Hypothermia Cpr Coronary Circulation Cardiopulmonary-resuscitation Cardiopulmonary resuscitation Adverse effect

Abstract: Background: There are data suggesting that passive leg raising (PLR) improves hemodynamics during cardiopulmonary resuscitation (CPR). This trial aimed to determine the effectiveness and safety of PLR during CPR in out-of-hospital cardiac arrest (OHCA). Methods: We conducted a randomized controlled trial with blinded assessment of the outcomes that assigned adults OHCA to be treated with PLR or in the flat position. The trial was conducted in the Camp de Tarragona region. The main end point was survival to hospital discharge with good neurological outcome defined as cerebral performance category (CPC 1–2). To study possible adverse effects, we assessed the presence of pulmonary complications on the first chest X-rays, brain edema on the computerized tomography (CT) in survivors and brain and lungs weights from autopsies in non-survivors. Results: In total, 588 randomized cases were included, 301 were treated with PLR and 287 were controls. Overall, 67.8% were men and the median age was 72 (IQR 60–82) years. At hospital discharge, 3.3% in the PLR group and 3.5% in the control group were alive with CPC 1–2 (OR 0.9; 95% CI 0.4–2.3, p = 0.91). No significant differences in survival at hospital admission were found in all patients (OR 1.0; 95% CI 0.7–1.6, p = 0.95) and among patients with an initial shockable rhythm (OR 1.7; 95% CI 0.8–3.4, p = 0.15). There were no differences in pulmonary complication rates in chest X-rays [7 (25.9%) vs 5 (17.9%), p = 0.47] and brain edema on CT [5 (29.4%) vs 10 (32.6%), p = 0.84]. There were no differences in lung weight [1223 mg (IQR 909–1500) vs 1239 mg (IQR 900–1507), p = 0.82] or brain weight [1352 mg (IQR 1227–1457) vs 1380 mg (IQR 1255–1470), p = 0.43] among the 106 autopsies performed. Conclusion: In this trial, PLR during CPR did not improve survival to hospital discharge with CPC 1–2. No evidence of adverse effects has been found. Clinical trial registration ClinicalTrials.gov: NCT01952197, registration date: September 27, 2013, https://clinicaltrials.gov/ct2/show/NCT01952197. [Figure not available: see fulltext.]

Thematic Areas: Saúde coletiva Nutrição Medicina veterinaria Medicina iii Medicina ii Medicina i Interdisciplinar Farmacia Engenharias iv Enfermagem Educação física Critical care medicine Critical care and intensive care medicine Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Ciência de alimentos Biotecnología

licence for use: https://creativecommons.org/licenses/by/3.0/es/

Author's mail: eneko.barberia@urv.cat eneko.barberia@urv.cat susana.alvarez@urv.cat maria.jimenez@urv.cat alberto.fernandez@urv.cat

Author identifier: 0000-0001-5804-3597 0000-0001-5804-3597 0000-0002-1376-2034 0000-0003-2599-3742 0000-0002-1241-1646

Record's date: 2023-02-23

Papper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://ccforum.biomedcentral.com/articles/10.1186/s13054-021-03593-7

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Critical Care. 25 (1):

APA: Azeli Y; Bardají A; Barbería E; Lopez-Madrid V; Bladé-Creixenti J; Fernández-Sender L; Bonet G; Rica E; Álvarez S; Fernández A; Axelsson C; Jiménez-He (2021). Clinical outcomes and safety of passive leg raising in out-of-hospital cardiac arrest: a randomized controlled trial. Critical Care, 25(1), -. DOI: https://doi.org/10.1186/s13054-021-03593-7

Article's DOI: https://doi.org/10.1186/s13054-021-03593-7

Entity: Universitat Rovira i Virgili

Journal publication year: 2021

Publication Type: Journal Publications