- Question
- To determine whether a restrictive or a liberal arterial oxygenation target is preferable during mechanical ventilation in comatose adults who survive out-of-hospital cardiac arrest.
- Design
- Randomized trial with a 2-by-2 factorial design (the second randomization, on blood pressure, is reported separately), with 1:1 allocation. A total of 789 patients were randomized; the registry describes quadruple masking.
- Population
- Comatose adults after out-of-hospital cardiac arrest who had been resuscitated and required mechanical ventilation.
- Intervention
- Restrictive oxygen target, with a partial pressure of arterial oxygen (PaO2) of 9 to 10 kPa (68 to 75 mm Hg), maintained during post-resuscitation targeted temperature management.
- Control
- Liberal oxygen target, with a PaO2 of 13 to 14 kPa (98 to 105 mm Hg).
- Primary outcome
- Composite of death from any cause or hospital discharge with severe disability or coma (Cerebral Performance Category [CPC] of 3 or 4), whichever occurred first within 90 days after randomization.
- Results
- A primary-outcome event occurred in 126 of 394 patients (32.0%) in the restrictive-target group and in 134 of 395 (33.9%) in the liberal-target group (HR 0.95; 95% CI 0.75 to 1.21; P = 0.69). At 90 days, 113 patients (28.7%) in the restrictive group and 123 (31.1%) in the liberal group had died.
- Safety
- The incidence of adverse events was similar in the two groups.
- Conclusion
- Targeting a restrictive or liberal oxygenation strategy in comatose patients after cardiac arrest resulted in a similar incidence of death or severe disability or coma.
- Why it matters
- It provided randomized evidence that, within these ranges, the oxygenation target does not change prognosis, giving clinicians flexibility when adjusting oxygen in post-resuscitation care.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026