Protocol for an individual patient data meta-analysis on blood pressure targets after cardiac arrest

Markus B. Skrifvars*, Koen Ameloot, Johannes Grand, Matti Reinikainen, Johanna Hästbacka, Ville Niemelä, Christian Hassager, Jesper Kjaergaard, Anders Åneman, Marjaana Tiainen, Niklas Nielsen, Susann Ullen, Josef Dankiewicz, Markus Harboe Olsen, Caroline Kamp Jørgensen, Manoj Saxena, Janus C. Jakobsen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

35 Downloads (Pure)


Background: Hypotension is common after cardiac arrest (CA), and current guidelines recommend using vasopressors to target mean arterial blood pressure (MAP) higher than 65 mmHg. Pilot trials have compared higher and lower MAP targets. We will review the evidence on whether higher MAP improves outcome after cardiac arrest. Methods: This systematic review and meta-analysis will be conducted based on a systematic search of relevant major medical databases from their inception onwards, including MEDLINE, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL), as well as clinical trial registries. We will identify randomised controlled trials published in the English language that compare targeting a MAP higher than 65–70 mmHg in CA patients using vasopressors, inotropes and intravenous fluids. The data extraction will be performed separately by two authors (a third author will be involved in case of disagreement), followed by a bias assessment with the Cochrane Risk of Bias tool using an eight-step procedure for assessing if thresholds for clinical significance are crossed. The outcomes will be all-cause mortality, functional long-term outcomes and serious adverse events. We will contact the authors of the identified trials to request individual anonymised patient data to enable individual patient data meta-analysis, aggregate data meta-analyses, trial sequential analyses and multivariable regression, controlling for baseline characteristics. The certainty of the evidence will be assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. We will register this systematic review with Prospero and aim to redo it when larger trials are published in the near future. Conclusions: This protocol defines the performance of a systematic review on whether a higher MAP after cardiac arrest improves patient outcome. Repeating this systematic review including more data likely will allow for more certainty regarding the effect of the intervention and possible sub-groups differences.

Original languageEnglish
Book seriesActa Anaesthesiologica Scandinavica
Issue number7
Pages (from-to)890-897
Publication statusPublished - Aug 2022

Bibliographical note

Publisher Copyright:
© 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.


  • cardiac arrest
  • cardiopulmonary resuscitation
  • mean arterial blood pressure
  • Blood Pressure
  • Meta-Analysis as Topic
  • Humans
  • Systematic Reviews as Topic
  • Heart Arrest/therapy


Dive into the research topics of 'Protocol for an individual patient data meta-analysis on blood pressure targets after cardiac arrest'. Together they form a unique fingerprint.

Cite this