Penna Alessio, Magliocca Aurora, Merigo Giulia, Stirparo Giuseppe, Silvestri Ivan, Fumagalli Francesca, Ristagno Giuseppe
Department of Pathophysiology and Transplantation, University of Milan, Via Festa del Perdono 1, 20122 Milan, Italy.
Department of Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy.
J Clin Med. 2023 Mar 14;12(6):2235. doi: 10.3390/jcm12062235.
Cardiac arrest, one of the leading causes of death, accounts for numerous clinical studies published each year. This review summarizes the findings of all the randomized controlled clinical trials (RCT) on cardiac arrest published in the year 2022. The RCTs are presented according to the following categories: out-of- and in-hospital cardiac arrest (OHCA, IHCA) and post-cardiac arrest care. Interestingly, more than 80% of the RCTs encompassed advanced life support and post-cardiac arrest care, while no studies focused on the treatment of IHCA, except for one that, however, explored the temperature control after resuscitation in this population. Surprisingly, 9 out of 11 RCTs led to neutral results demonstrating equivalency between the newly tested interventions compared to current practice. One trial was negative, showing that oxygen titration in the immediate pre-hospital post-resuscitation period decreased survival compared to a more liberal approach. One RCT was positive and introduced new defibrillation strategies for refractory cardiac arrest. Overall, data from the 2022 RCTs discussed here provide a solid basis to generate new hypotheses to be tested in future clinical studies.
心脏骤停是主要死因之一,每年都有大量相关临床研究发表。本综述总结了2022年发表的所有关于心脏骤停的随机对照临床试验(RCT)的结果。这些RCT按以下类别呈现:院外和院内心脏骤停(OHCA、IHCA)以及心脏骤停后护理。有趣的是,超过80%的RCT涵盖了高级生命支持和心脏骤停后护理,而除了一项探索该人群复苏后体温控制的研究外,没有研究关注IHCA的治疗。令人惊讶的是,11项RCT中有9项得出中性结果,表明新测试的干预措施与当前做法相当。一项试验结果为阴性,表明与更宽松的方法相比,院前复苏后立即进行氧滴定会降低生存率。一项RCT结果为阳性,并引入了针对难治性心脏骤停的新除颤策略。总体而言,本文讨论的2022年RCT数据为生成未来临床研究中有待检验的新假设提供了坚实基础。