A promising emerging treatment (hypercapnia) for comatose adult cardiac arrest patients has been found to yield similar results to current treatment, in a new study published today in the prestigious medical journal New England Journal of Medicine (NEJM).
Co-lead author, Professor Alistair Nichol (pictured), Professor of Critical Care Medicine at UCD School of Medicine, Consultant at St 
Vincent’s University Hospital and Director of the Irish Critical Care-Clinical Trials Network, leads the TAME study in Ireland – funded by the Health Research Board (HRB).
Professor Nichol said: “Our study impacts clinical practice and future cardiac arrest research in a number of ways. Firstly, while we found no additional harm from targeting hypercapnia in these patients, the lack of benefit means there’s no need to change practice at present. So, doctors can rest assured that patients aren’t missing out if they receive standard practice.
“The second is that while we are somewhat disappointed we haven't discovered a new therapy to improve outcomes for these patients, we demonstrated that these patients can tolerate hypercapnia without causing any harm. This can be important in ICU settings, as this allows doctors to less intensely ventilate patients on breathing machines, which can be helpful in some patient groups.
“Thirdly, it points to a need for further trials and basic science research, as we seem to have a gap in our knowledge and theories about the role of arterial CO2, and how it impacts the body’s responses. While hypercapnia didn’t improve outcomes in this study, this is not the end of the story for carbon dioxide management in the critically ill. Relevant work is now being conducted, to discover which blood markers can determine good outcomes and allow identification of these patients earlier. We’ve also established a global network of OHCA hospitals and investigators which are now turning to answer the next important question in this patient group.”
The results were published in the journal in a coordinated release with the Critical Care Reviews 2023 Meeting in Belfast.
Congratulations to Prof Nichol and the team.
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