Point-of-care laboratory analyses of intraosseous, arterial and central venous samples during experimental cardiopulmonary resuscitation

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http://hdl.handle.net/10138/312429

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Jousi , M , Skrifvars , M B , Nelskylä , A , Ristagno , G , Schramko , A & Nurmi , J 2019 , ' Point-of-care laboratory analyses of intraosseous, arterial and central venous samples during experimental cardiopulmonary resuscitation ' , Resuscitation , vol. 137 , pp. 124-132 . https://doi.org/10.1016/j.resuscitation.2019.02.014

Titel: Point-of-care laboratory analyses of intraosseous, arterial and central venous samples during experimental cardiopulmonary resuscitation
Författare: Jousi, Mille; Skrifvars, Markus B.; Nelskylä, Annika; Ristagno, Giuseppe; Schramko, Alexey; Nurmi, Jouni
Upphovmannens organisation: HUS Emergency Medicine and Services
Anestesiologian yksikkö
Department of Diagnostics and Therapeutics
Clinicum
University of Helsinki
HUS Perioperative, Intensive Care and Pain Medicine
Datum: 2019-04
Språk: eng
Sidantal: 9
Tillhör serie: Resuscitation
ISSN: 0300-9572
DOI: https://doi.org/10.1016/j.resuscitation.2019.02.014
Permanenta länken (URI): http://hdl.handle.net/10138/312429
Abstrakt: Introduction: Screening and correcting reversible causes of cardiac arrest (CA) are an essential part of cardiopulmonary resuscitation (CPR). Point-ofcare (POC) laboratory analyses are used for screening pre-arrest pathologies, such as electrolyte disorders and acid-base balance disturbances. The aims of this study were to compare the intraosseous (10), arterial and central venous POC values during CA and CPR and to see how the CPR values reflect the pre-arrest state. Methods: We performed an experimental study on 23 anaesthetised pigs. After induction of ventricular fibrillation (VF), we obtained POC samples from the 10 space, artery and central vein simultaneously at three consecutive time points. We observed the development of the values during CA and CPR and compared the CPR values to the pre-arrest values. Results: The 10, arterial and venous values changed differently from one another during the course of CA and CPR. Base excess and pH decreased in the venous and 10 samples during untreated VF, but in the arterial samples, this only occurred after the onset of CPR. The 10, arterial and venous potassium values were higher during CPR compared to the pre-arrest arterial values (mean elevations 4.4 mmol/l (SD 0.72), 3.3 mmol/l (0.78) and 2.8 mmol/l (0.94), respectively). Conclusions: A dynamic change occurs in the common laboratory values during CA and CPR. POC analyses of lactate, pH, sodium and calcium within 10 samples are not different from analyses of arterial or venous blood. Potassium values in 10, arterial and venous samples during CPR are higher than the pre-arrest arterial values.
Subject: Intra-osseous access
Cardiopulmonary resuscitation
Resuscitation
Point-of-care
Laboratory analysis
Blood gas analysis
Emergency medicine
ACID-BASE STATUS
CARDIAC-ARREST
BLOOD-GASES
COUNCIL GUIDELINES
VASCULAR ACCESS
SITES
3126 Surgery, anesthesiology, intensive care, radiology
Referentgranskad: Ja
Användningsbegränsning: openAccess
Parallelpublicerad version: acceptedVersion


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