{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T01:58:28Z","timestamp":1785376708448,"version":"3.55.0"},"reference-count":58,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002341","name":"Research Council of Finland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006306","name":"Sigrid Jus\u00e9liuksen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010116","name":"Medicinska Underst\u00f6dsf\u00f6reningen Liv och H\u00e4lsa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010116","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007247","name":"Svenska Kulturfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007247","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010119","name":"Stiftelsen Dorothea Olivia, Karl Walter och Jarl Walter Perkl\u00e9ns Minne","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010119","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Acute kidney injury (AKI) is a common and serious complication after cardiac arrest, affecting more than 30% of initially successfully resuscitated patients, with around 10% receiving Kidney Replacement Therapy (KRT). Currently, treatment options to prevent renal complications are limited. In this predefined sub\u2010study of the Sedation, TEmperature and Pressure after Cardiac Arrest and REsuscitation (STEPCARE) trial, we evaluate the effects of sedation depth, fever management strategies, and mean arterial pressure (MAP) targets on the risk of major adverse kidney events (MAKE) in post\u2010cardiac arrest patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n STEPCARE\u2010MAKE is a predefined prospective sub\u2010study of the international, randomized clinical STEPCARE trial. The main trial will enroll 3500 patients and employs a 2\u2009\u00d7\u20092\u2009\u00d7\u20092 factorial design, randomizing participants across three interventions: (1) deep sedation for 36\u2009h or minimal sedation, (2) fever management with or without a feedback\u2010controlled device, and (3) MAP target \u2265\u200965\u2009mmHg or\u2009\u2265\u200985\u2009mmHg. The primary outcome is the composite outcome MAKE, which includes death from any cause by day 30, initiation of KRT, or persistent renal dysfunction, defined as the final creatinine value \u2265\u2009200% of the baseline at the time of discharge from the primary hospital or at day 30, whichever occurs first. Differences between baseline and the highest in\u2010hospital creatinine, baseline and the last measured in\u2010hospital creatinine, baseline and 72\u2010h creatinine, and baseline and the highest creatinine within 72\u2009h will be reported as secondary outcomes.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The findings of this sub\u2010study will provide new evidence on the renal effects of the STEPCARE trial interventions and may inform the future of individualized kidney\u2010protective treatment approaches.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aas.70276","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:34:18Z","timestamp":1781584458000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Sedation,\n TEmperature<\/scp>\n and Pressure After Cardiac Arrest and\n REsuscitation<\/scp>\n on Major Adverse Kidney Events (\n STEPCARE<\/scp>\n \u2010\n MAKE<\/scp>\n ): A Protocol for a Pre\u2010Planned Sub\u2010Study of a Randomized Clinical Trial"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3759-8164","authenticated-orcid":false,"given":"Keski\u2010Keturi","family":"M","sequence":"first","affiliation":[{"name":"Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niemel\u00e4","family":"V.H","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young","family":"P","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Wellington Hospital Wellington New Zealand"},{"name":"Medical Research Institute of New Zealand Wellington New Zealand"},{"name":"Australian and New Zealand Intensive Care Research Centre, Monash University Melbourne Victoria Australia"},{"name":"Department of Critical Care University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nielsen","family":"N","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund Anesthesia and Intensive Care, Lund University Lund Sweden"},{"name":"Department of Anesthesia and Intensive Care Helsingborg Hospital Helsingborg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wise","family":"M.P","sequence":"additional","affiliation":[{"name":"Adult Critical Care, University Hospital of Wales Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6878-3740","authenticated-orcid":false,"given":"Reinikainen","family":"M","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine University of Eastern Finland Kuopio Finland"},{"name":"Department of Anesthesiology and Intensive Care Kuopio University Hospital Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bass","family":"F","sequence":"additional","affiliation":[{"name":"Critical Care Program, the George Institute for Global Health, UNSW Sydney Australia"},{"name":"Malcolm Fisher Department of Intensive Care Royal North Shore Hospital St Leonards Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1860-1456","authenticated-orcid":false,"given":"Lilja","family":"G","sequence":"additional","affiliation":[{"name":"Neurology, Department of Clinical Sciences Lund Lund University Lund Sweden"},{"name":"Department of Neurology Sk\u00e5ne University Hospital Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dankiewicz","family":"J","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund Section of Cardiology, Sk\u00e5ne University Hospital Lund 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