The Specification of Array-Based Algorithms and the Automated Derivation of Parallel Implementations through Program Transformation

programming and program transformation. In Ted J. Biggerstaff and Alan J. Perlis, editors, Software Reusability, volume 1, pages 361--413. ACM Press/AddisonWesley, 1989. [21] James M. Boyle and Terence J. Harmer. Functional specifications for mathematical computations. In B. Moller, editor, Proceedings of the IFIP TC2/WG2.1 Working Conference on Construction of Programs from Specifications, pages 205--224, 1991. [22] James M. Boyle and Terence J. Harmer. A practical functional program for the CRAY X-MP. Journal of Functional Programming, 2(1):81--126, 1992. [23] James M. Boyle and Managur N. Muralidharan. Program reusability through program transformation. IEEE Transactions on Software Engineering, 10(5):574--588, September 1984. [24] Tore A. Bratvold. Determining useful parallelism in higher order functions. In Herbert Kuchen and Rita Loogen, editors, 4th International Workshop on the Parallel Implementation of Functional Languages, September 1992. [25] R. M. Burstall and John Darli..

Ventilatory settings in the initial 72 h and their association with outcome in out-of-hospital cardiac arrest patients: a preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest (TTM2) trial

International audienc

Oxygen targets and 6-month outcome after out of hospital cardiac arrest: a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial

International audienceAbstract Background Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO 2 ) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO 2 with patients’ outcome. Methods Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO 2  300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. Results 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93–1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95–1.06). The time exposure, i.e., the area under the curve (PaO 2 -AUC), for hyperoxemia was significantly associated with mortality ( p = 0.003). Conclusions In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. Trial registration : clinicaltrials.gov NCT02908308 , Registered September 20, 2016