BOX Trial Summary: Oxygen Targets in Comatose Survivors of Cardiac Arrest

box trial oxygen

2022 BOX TRIAL: OXYGEN TARGETS IN OHCA Oxygen targets in comatose survivors of cardiac arrest Investigator-initiated, open-label, superiority,2×2 factorial design, randomized clinical trial Objective: To evaluate the appropriate oxygen target for mechanical ventilation in comatose survivors of out-of-hospital cardiac arrest 789 Inclusion criteria: 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 O2 Restrictive-target (Pao2 68 to 75 mmHg) Liberal-target (Pao2 98to 105 mmHg) PRIMARY OUTCOME 32.0 Composite of death or hospital discharge with severe disability or coma within 90 days % HR 0.95; 95% CI, 0.75 to 1.21; P=0.69 33.9 SECONDARY OUTCOMES 28.7 Death at 90 days % HR 0.93; 95% CI, 0.72 to 1.20 31.1 Median score on the modified Rankin scale 17 Median neuron-specific enolase levels (ug/L) 18 Conclusion: Targeting of a restrictive or liberal oxygenation strategy in comatose patients after resuscitation for cardiac arrest resulted in a similar incidence of death or severe disability or coma. H Schmidt et al. DOI: 10.1056/NEJMoa2208686