08/05/2019 Early hyperoxemia is not associated with cardiac arrest outcome - Resuscitation

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Jaana Humalojaa, , , Erik Litoniusb, Ilmar Efendijevb, Daniel Folgerb, Rahul Rajc, Pirkka T. Pekkarinenb, Add to My Reading List
Markus B. Skrifvarsa,b Export Citation
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DOI: https://doi.org/10.1016/j.resuscitation.2019.04.035

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Abstract Traumatic cardiac arrest is associated

with lower survival rate vs. medical
Aim cardiac arrest – Results from the French
national registry
Can Studies
we treatsuggest that hyperoxemia increases short-term mortality after cardiopulmonary resuscitation (CPR), but Resuscitation, Vol. 131
post cardiac Health care utilization prior
arrestthe effectbyofremoving
shock hyperoxemia on long-term outcomes is unclear. We determined the prevalence of early to out-of-hospital cardiac
cytokines
hyperoxemia
from circulation
after CPR and its association with long-term neurological outcome and mortality. Arrest etiology among arrest: A population-based
patients
with high cut-off veno- study arrest
resuscitated from cardiac
venous hemodialysis? Shuvy, Mony et al.
Resuscitation, Vol. 130
Methods
Pekkarinen, Pirkka
T.Skrifvars,
We analysed
MarkusdataB.Varon,
from adult cardiac arrest patients treated after CPR in tertiary ICUs during 2005–2013. We
Cardiac Arrest and Cardiopulmonary
Joseph et al. data from the resuscitation and the first arterial blood sample collected after return of spontaneous
retrieved Resuscitation Outcome Reports: Update
circulation (ROSC) (severe hyperoxemia defined as PaO2 > 40 kPa and moderate as PaO2 16–40 kPa). We of the Utstein Resuscitation Registry
inspected two outcomes, neurological performance at one year after resuscitation according to the Cerebral Templates for Out-of-Hospital Cardiac
Arrest: A Statement for Healthcare
Performance Category and one-year mortality. We used logistic regression to test associations between Professionals From a Task Force of the
hyperoxemia and the outcome and interaction analyses to test the effect of hyperoxemia exposure on the International Liaison Committee on
outcomes in smaller subgroups. Resuscitation (American Heart
Association, European Resuscitation
Council, Australian and New Zealand
Results Council on Resuscitation, Heart and
Stroke Foundation of Canada,
Of 1110 patients 11% had severe hyperoxemia, prevalence was 10% for out-of-hospital arrests, 13% for in- InterAmerican Heart Foundation,
hospital arrests and 9% for in-ICU arrests. In total 585(53%) patients had an unfavourable neurological outcome. Resuscitation Council of Southern Africa,
Compared to normoxemia, severe (Odds ratio [OR] 0.81, 95% confidence interval [CI] 0.50–1.30) and moderate Resuscitation Council of Asia); and the
hyperoxemia (OR 0.94 95%CI 0.69–1.27) did not associate with neurological outcome. Additionally, American Heart Association Emergency
Cardiovascular Care Committee and the
hyperoxemia had no association with mortality. In subgroup analyses there were no significant associations Council on Cardiopulmonary, Critical
between severe hyperoxemia and outcomes regardless of cardiac arrest location, initial rhythm or time-to- Care, Perioperative and Resuscitation
ROSC. Resuscitation, Vol. 96

Reasons for death in patients

Conclusion successfully resuscitated from out-of-
We found no association between early post-arrest hyperoxemia and unfavourable outcome. Subgroup analysis hospital and in-hospital cardiac arrest
found no differential effect depending on arrest location, initial rhythm or time-to-ROSC. Resuscitation, Vol. 136

Implementation of the Cardiac Arrest

Sonographic Assessment (CASA)
protocol for patients with cardiac arrest is
Keywords: associated with shorter CPR pulse checks
Cardiac arrest, Post cardiac arrest care, Hyperoxia, Hyperoxemia, Post resuscitation care, Neurological Resuscitation, Vol. 131
outcome, Cardiac arrest outcome, Intensive care after cardiac arrest, Out of hospital cardiac, arrest, In hospital
cardiac arrest, Intensive care unit cardiac arrest
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Can we treat post cardiac Health care utilization prior

arrest shock by removing to out-of-hospital cardiac
cytokines from circulation arrest: A population-based
with high cut-off veno- study
venous hemodialysis? Shuvy, Mony et al.
Pekkarinen, Pirkka
T.Skrifvars, Markus B.Varon,
Joseph et al.

https://www.resuscitationjournal.com/article/S0300-9572(19)30151-0/pdf 2/2