BOX Trial Summary: BP Target in OHCA

box trial blood pressure in cardiac arrest

2022 BOX TRIAL: BP TARGETS IN OHCA Blood-pressure targets in comatose survivors of cardiac arrest Investigator-initiated, double-blind, superiority, 2×2 factorial design, randomized clinical trial Objective: To evaluate the appropriate blood pressure target in comatose survivors of out-of-hospital cardiac arrest 789 Adults 18 years admitted to the hospital after resuscitated cardiac arrest (of presumed cardiac cause); Unconscious (GCS <8); Sustained return of spontaneous circulation; targeted temperature management indicated patients VS High BP-target: MAP=63mmHg Low BP-target: MAP=77mmHg. PRIMARY OUTCOME Composite of death or hospital discharge with severe disability or coma within 90 days % HR 1.08; 95% CI, 0.84 to 1.37; P=0.56 SECONDARY OUTCOMES Death at 90 days % HR1.13; 95% CI, 0.72 to 1.20 29 27 Median Montreal Cognitive Assessment score Median CPC, mRS scores & neuron-specific enolase levels were similar in both the groups Conclusion: Targeting a mean arterial blood pressure of 77 mm Hg or 63 mm Hg in patients who had been resuscitated from cardiac arrest did not result in significantly different percentages of patients dying or having severe disability or coma Kjaergaard et al. DOI: 10.1056/NEJMoa2208687