Format

Send to

Choose Destination
Ther Hypothermia Temp Manag. 2017 Mar;7(1):36-41. doi: 10.1089/ther.2016.0015. Epub 2016 Jul 6.

The Association Between Arterial Oxygen Tension and Neurological Outcome After Cardiac Arrest.

Author information

1
1 Division of Pulmonary and Critical Care Medicine, University of Washington , Seattle, Washington.
2
2 School of Public Health, Drexel University , Philadelphia, Pennsylvania.
3
3 OhioHealth , Columbus, Ohio.
4
4 Department of Emergency Medicine, University of Colorado School of Medicine , Aurora, Colorado.
5
5 Division of Pulmonary, Allergy, and Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
6
6 Department of Emergency Medicine, Medstar Washington Hospital Center , Washington, District of Columbia.
7
7 Department of Emergency Medicine, Thomas Jefferson University , Philadelphia, Pennsylvania.
8
8 Department of Emergency Medicine, Center for Resuscitation Science, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.

Abstract

A number of observational studies have evaluated the association between arterial oxygen tensions and outcome after cardiac arrest with variable results. The objective of this study is to determine the association between arterial oxygen tension and neurological outcome after cardiac arrest. A retrospective cohort analysis was performed using the Penn Alliance for Therapeutic Hypothermia registry. Adult patients who experienced return of spontaneous circulation after in-hospital or out-of-hospital cardiac arrest (OHCA) and had a partial pressure of arterial oxygen (PaO2) recorded within 48 hours were included. Our primary exposure of interest was PaO2. Hyperoxemia was defined as PaO2 > 300 mmHg, hypoxemia as PaO2 < 60 mmHg, and optimal oxygenation as PaO2 60-300 mmHg. The primary outcome was neurological function at hospital discharge among survivors, as described by the cerebral performance category (CPC) score, dichotomized into "favorable" (CPCs 1-2) and "unfavorable" (CPCs 3-5). Secondary outcomes included in-hospital mortality. A total of 544 patients from 13 institutions were included. Average age was 61 years, 56% were male, and 51% were white. A total of 64% experienced OHCA, 81% of arrests were witnessed, and pulseless electrical activity was the most common initial rhythm (40%). More than 72% of the patients had cardiac etiology for their arrests, and 55% underwent targeted temperature management. A total of 38% of patients survived to hospital discharge. There was no significant association between PaO2 at any time interval and neurological outcome at hospital discharge. Hyperoxemia at 12 hours after cardiac arrest was associated with decreased odds of survival (OR 0.17 [0.03-0.89], p = 0.032). There was no significant association between arterial oxygen tension measured within the first 48 hours after cardiac arrest and neurological outcome.

KEYWORDS:

cardiac arrest; critical care; hyperoxia; post-arrest care; ventilator management

PMID:
27383062
DOI:
10.1089/ther.2016.0015
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center