Early hyperoxemia is not associated with cardiac arrest outcome

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Humaloja , J , Litonius , E , Efendijev , I , Folger , D , Raj , R , Pekkarinen , P T & Skrifvars , M B 2019 , ' Early hyperoxemia is not associated with cardiac arrest outcome ' , Resuscitation , vol. 140 , pp. 185-193 . https://doi.org/10.1016/j.resuscitation.2019.04.035

Title: Early hyperoxemia is not associated with cardiac arrest outcome
Author: Humaloja, Jaana; Litonius, Erik; Efendijev, Ilmar; Folger, Daniel; Raj, Rahul; Pekkarinen, Pirkka T.; Skrifvars, Markus B.
Contributor: University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Anestesiologian yksikkö
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki, Neurokirurgian yksikkö
University of Helsinki, Anestesiologian yksikkö
University of Helsinki, HUS Emergency Medicine and Services
Date: 2019-07
Language: eng
Number of pages: 9
Belongs to series: Resuscitation
ISSN: 0300-9572
URI: http://hdl.handle.net/10138/316919
Abstract: Aim: Studies suggest that hyperoxemia increases short-term mortality after cardiopulmonary resuscitation (CPR), but the effect of hyperoxemia on long-term outcomes is unclear. We determined the prevalence of early hyperoxemia after CPR and its association with long-term neurological outcome and mortality. Methods: We analysed data from adult cardiac arrest patients treated after CPR in tertiary ICUs during 2005-2013. We retrieved data from the resuscitation and the first arterial blood sample collected after return of spontaneous circulation (ROSC) (severe hyperoxemia defined as PaO2 > 40 kPa and moderate as PaO2 16-40 kPa). We inspected two outcomes, neurological performance at one year after resuscitation according to the Cerebral Performance Category and one-year mortality. We used logistic regression to test associations between hyperoxemia and the outcome and interaction analyses to test the effect of hyperoxemia exposure on the outcomes in smaller subgroups. Results: Of 1110 patients 11% had severe hyperoxemia, prevalence was 10% for out-of-hospital arrests, 13% for in-hospital arrests and 9% for in-ICU arrests. In total 585(53%) patients had an unfavourable neurological outcome. Compared to normoxemia, severe (Odds ratio [OR] 0.81, 95% confidence interval [CI] 0.50-1.30) and moderate hyperoxemia (OR 0.94 95%CI 0.69-1.27) did not associate with neurological outcome. Additionally, hyperoxemia had no association with mortality. In subgroup analyses there were no significant associations between severe hyperoxemia and outcomes regardless of cardiac arrest location, initial rhythm or time-to-ROSC. Conclusion: We found no association between early post-arrest hyperoxemia and unfavourable outcome, Subgroup analysis found no differential effect depending on arrest location, initial rhythm or time-to-ROSC.
Subject: Cardiac arrest
Post cardiac arrest care
Hyperoxia
Hyperoxemia
Post resuscitation care
Neurological outcome
Cardiac arrest outcome
Intensive care after cardiac arrest
Out of hospital cardiac
arrest
In hospital cardiac arrest
Intensive care unit cardiac arrest
EUROPEAN-RESUSCITATION-COUNCIL
ARTERIAL HYPEROXIA
PARTIAL-PRESSURE
SECTION 4
OXYGEN
GUIDELINES
METAANALYSIS
REPERFUSION
DEATH
3126 Surgery, anesthesiology, intensive care, radiology
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