TNF-α Antagonists Mitigate Systemic Inflammatory Response After Cardiac Arrest.

Inclusion criteria

• Patients aged ≥18 years;
• Patients with suspected cardiogenic cardiac arrest;
• Patients with comatose state after ROSC (Glasgow Coma Scale [GCS] score <9);
• Patients with Return of spontaneous circulation (ROSC) sustained for >20 minutes;

Exclusion criteria

• Cardiac arrest due to trauma;
• Suspected or confirmed hemorrhagic or ischemic stroke;
• Pregnancy;
• Cardiac arrest without witnessed collapse;
• Admission body temperature <30°C;
• Persistent cardiogenic shock (defined as systolic blood pressure below 90mmHg during the screening period despite adequate fluid resuscitation, vasopressors, and positive inotropic drug support);
• Time from ROSC to randomization exceeding 4 hours;
• Left ventricular ejection fraction (LVEF) <35% after ROSC;
• Known allergy to TNF - α antagonist components
• Known tuberculosis or other active infection;
• Diagnosed advanced malignant tumors with an estimated survival period of less than 6 months;
• Pre-existing severe neurological dysfunction before cardiac arrest (e.g., Cerebral Performance Category [CPC] 3-4);
• End stage renal disease relies on dialysis;
• Severe chronic obstructive pulmonary disease (COPD) and other diseases require long-term home oxygen therapy;
• Being in a state of severe immune suppression (such as long-term use of immunosuppressants after autoimmune diseases or organ transplantation, or patients with severe immunodeficiency diseases)；
• History of liver cirrhosis;
• History of chronic heart failure, heart function III-IV (NYHA)