Research Article
Year 2020,
Volume: 42 Issue: 3, 366 - 374, 27.10.2020
Abstract
References
- 1. Robert W. Neumar, Chair, Shuster, Michael ve al., Clifton W. Callaway et 2015 American Heart Association Guidelines Update for Cardiopulmonary. Circulation. 2015;132 (suppl 2):S315–S367. 2. Jan M. Shoenberger, Kristy Massopust, Sean O. Henderson. The Use of Bedside Ultrasound in Cardiac Arrest. Cal J Emerg Med. 2007 May; 8(2): 47–50. 3. O. Tomruk, B. Erdur, G. Cetin, A. Ergin, M. Avcil and M. Kapci, Assessment of Cardiac Ultrasonography in Predicting Outcome in Adult Cardiac Arrest. Journal of International Medical Research. Issue published: April 1, 2012 Volume: 40 issue: 2, page(s): 804-809. 4. Hope Kilgannon J, Hunter BR, Puskarich MA et al. Partial pressure of arterial carbon dioxide after resuscitation from cardiac arrest and neurological outcome: A prospective multi-center protocol-directed cohort study. basım yeri bilinmiyor : Resuscitation (2018), https://doi.org/10.1016/j.resuscitation.2018.11.015. 5. Jonghwan Shin, Yong Su Lim, Kyuseok Kim et al. Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicenter observational registry-based study: Critical Care 2017 21:322 https://doi.org/10.1186/s13054-017-1893-9. 6. Wang HE, Prince DK, Drennan IR. Post-resuscitation arterial oxygen and carbon dioxide and outcomes after out-of-hospital cardiac arrest. Resuscitation. 2017 Nov;120:113-118. doi: 10.1016/j.resuscitation.2017.08.244. Epub 2017 Sep 21. 7. Youn-Jung Kim, MD, You Jin Lee, MD, Seung Mok Ryoo. Role of blood gas analysis during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients. Medicine (Baltimore). 2016 Jun; 95(25): e3960. Published online 2016 Jun 24. doi: 10.1097/MD.00. 8. Satoshi Gando, IchiroTedo, Munehiro Kubota. A comparison of serum ionized calcium in arterial and mixed venous blood during CPR. Annals of Emergency Medicine Volume 19, Issue 8, August 1990, Pages 850-856. 9. Mu Jin Kim, Kyung Woon Jeung, Byung Kook Lee et al. Femoral venous oxygen saturation obtained during CPR predicts successful resuscitation in a pig model. The American Journal of Emergency Medicine July 2015 Volume 33, Issue 7, Pages 941–945. 10. Matej Strnad, Damjan Lešnik and Miljenko Križmarić. Arterial blood gas changes during cardiac arrest and cardiopulmonary resuscitation combined with passive oxygenation/ventilation: a METI HPS study. J Int Med Res. 2018 Nov; 46(11): 4605–4616. . 11. Kilgannon JH, Chansky ME, Mittal N, Wooden J, Trzeciak S. Association between postresuscitation partial pressure of arterial carbon dioxide and neurological outcome in patients with post-cardiac arrest syndrome. Circulation. Roberts BW, 2013;127:2107-13., 12. Roberts BW, Kilgannon JH, Chansky ME, Trzeciak S. Association between initial prescribed minute ventilation and post-resuscitation partial pressure of arterial carbon dioxide in patients with post-cardiac arrest syndrome. Annals of intensive care. 2014;4:. 13. Kim YJ, Lee YJ, Ryoo SM, Sohn CH, Ahn S, Seo DW, Lim KS, Kim WY. Role of blood gas analysis during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients. Medicine (Baltimore). 2016 Jun; 95(25): e3960. . 14. Kilgannon JH1, Jones AE, Shapiro NI, Angelos MG et al. Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. JAMA. 2010 Jun 2;303(21):2165-71. doi: 10.1001/jama.2010.707. 15. Prause G, Ratzenhofer-Comenda B, Smolle-Jüttner F,et al. Comparison of lactate or BE during out-of-hospital cardiac arrest to determine metabolic acidosis. Resuscitation. 2001 Dec;51(3):297-300. 16. Eastwood GM, Schneider AG, Suzuki S, Peck L, Young H, Tanaka A, et al. Targeted therapeutic mild hypercapnia after cardiac arrest: A phase II multi-centre randomised controlled trial (the CCC trial). Resuscitation. 2016;104:83-90. 17. Helmerhorst HJ, Roos-Blom MJ, van Westerloo DJ, Abu-Hanna A, de Keizer NF, de Jonge E. Associations of arterial carbon dioxide and arterial oxygen concentrations with hospital mortality after resuscitation from cardiac arrest. Crit Care. 2015;19:348. 18. Roberts BW, Kilgannon JH, Chansky ME, Mittal N, Wooden J, Trzeciak S. Association between postresuscitation partial pressure of arterial carbon dioxide and neurological outcome in patients with post cardiac arrest syndrome. Circulation. 2013 ve 127:2107-13. 19. Hazinski MF, Nolan JP, Billi JE, et al. Part 1: Executive Summary: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. In press. 20. Part 1: Executive Summary. 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015;132:S315-367. 21. Yundt KD, Diringer MN. The use of hyperventilation and its impact on cerebral ischemia in the treatment of traumatic brain injury. Crit Care Clin. 1997;13:163-84. 22. Roberts BW, Karagiannis P, Coletta M, Kilgannon JH, Chansky ME, Trzeciak S.Effects of PaCO2 derangements on clinical outcomes after cerebral injury: A systematic review. Resuscitation. 2015 Jun;91:32-41. doi: 10.1016/j.resuscitation.2015.03.015. Epub 2015. 23. Callaway CW, Donnino M, Fink E, Geocadin RG, Golan E, Kern KB, et al. Part 8: Post-cardiac arrest care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132:S465-S82. 24. Nolan JP, Hazinski MF, Aickin R, Bhanji F, Billi JE, Callaway CW, et al. Part 1: Executive summary: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation. 2015. 25. Eastwood GM, Tanaka A, Bellomo R. Cerebral oxygenation in mechanically ventilated early cardiac arrest survivors: The impact of hypercapnia. Resuscitation. 2016;102:11-6.
The value of initial blood gas analysis in predicting the outcome of cardiopulmonary resuscitation among in-of-hospital cardiac arrest patients
Abstract
Abstract
Objectives
The aim of this study was to determine the value of blood gas parameters in predicting return of spontaneous circulation (ROSC) in patients with in-hospital cardiopulmonary arrest (CPA).
Methods
Adult patients with in-hospital cardiac arrest, and with blood gas analysis obtained on the first 10 min of CPR were included in the study. Patients were divided into two groups based on CPR outcomes, ROSC and non-ROSC. The ability of blood gas parameters to differentiate these two groups was subjected to statistical analysis.
Results
Sixty-seven patients, ROSC was achieved in 14 and could not achieved in 53, were accepted to study. The ability of PH, HCO3, PaCO2, PaO2, lactate, base deficit and potassium to differentiate the two groups was calculated, and only bicarbonate to found to exhibit a statistically significant difference between the two [ p:0.040; Area under ROC: 0.672; 64.2% sensitivity (95% CI; 35.1% - 87.2%), 58.4% specificity (95% CI; 44.1% - 71.8%)]. PaCO2 values of ROSC patients concentrated in the 57-108 mmHg range. Sensitivity of 75.4% (41.9-91.6%) and a positive predictive value of 88.9% (79.5-94.2%) in predicting ROSC were calculated for this range.
Conclusion
No statistical value was determined for any blood gas parameter, apart from bicarbonate, in predicting ROSC and non-ROSC. The value of bicarbonate was also limited. However, there may be a secondary relation between PaCO2 values and CPR outcomes. Moderate-high (57-108 mmHg) PaCO2 values may be useful in the establishment of ROSC. This hypothesis now needs to be confirmed with more extensive studies.
Keywords
Thanks
The authors would like to thank Nalan Gokce Celebi Yamanoğlu for her data acquisition and assistance at the ethical committee stage.
References
- 1. Robert W. Neumar, Chair, Shuster, Michael ve al., Clifton W. Callaway et 2015 American Heart Association Guidelines Update for Cardiopulmonary. Circulation. 2015;132 (suppl 2):S315–S367. 2. Jan M. Shoenberger, Kristy Massopust, Sean O. Henderson. The Use of Bedside Ultrasound in Cardiac Arrest. Cal J Emerg Med. 2007 May; 8(2): 47–50. 3. O. Tomruk, B. Erdur, G. Cetin, A. Ergin, M. Avcil and M. Kapci, Assessment of Cardiac Ultrasonography in Predicting Outcome in Adult Cardiac Arrest. Journal of International Medical Research. Issue published: April 1, 2012 Volume: 40 issue: 2, page(s): 804-809. 4. Hope Kilgannon J, Hunter BR, Puskarich MA et al. Partial pressure of arterial carbon dioxide after resuscitation from cardiac arrest and neurological outcome: A prospective multi-center protocol-directed cohort study. basım yeri bilinmiyor : Resuscitation (2018), https://doi.org/10.1016/j.resuscitation.2018.11.015. 5. Jonghwan Shin, Yong Su Lim, Kyuseok Kim et al. Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicenter observational registry-based study: Critical Care 2017 21:322 https://doi.org/10.1186/s13054-017-1893-9. 6. Wang HE, Prince DK, Drennan IR. Post-resuscitation arterial oxygen and carbon dioxide and outcomes after out-of-hospital cardiac arrest. Resuscitation. 2017 Nov;120:113-118. doi: 10.1016/j.resuscitation.2017.08.244. Epub 2017 Sep 21. 7. Youn-Jung Kim, MD, You Jin Lee, MD, Seung Mok Ryoo. Role of blood gas analysis during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients. Medicine (Baltimore). 2016 Jun; 95(25): e3960. Published online 2016 Jun 24. doi: 10.1097/MD.00. 8. Satoshi Gando, IchiroTedo, Munehiro Kubota. A comparison of serum ionized calcium in arterial and mixed venous blood during CPR. Annals of Emergency Medicine Volume 19, Issue 8, August 1990, Pages 850-856. 9. Mu Jin Kim, Kyung Woon Jeung, Byung Kook Lee et al. Femoral venous oxygen saturation obtained during CPR predicts successful resuscitation in a pig model. The American Journal of Emergency Medicine July 2015 Volume 33, Issue 7, Pages 941–945. 10. Matej Strnad, Damjan Lešnik and Miljenko Križmarić. Arterial blood gas changes during cardiac arrest and cardiopulmonary resuscitation combined with passive oxygenation/ventilation: a METI HPS study. J Int Med Res. 2018 Nov; 46(11): 4605–4616. . 11. Kilgannon JH, Chansky ME, Mittal N, Wooden J, Trzeciak S. Association between postresuscitation partial pressure of arterial carbon dioxide and neurological outcome in patients with post-cardiac arrest syndrome. Circulation. Roberts BW, 2013;127:2107-13., 12. Roberts BW, Kilgannon JH, Chansky ME, Trzeciak S. Association between initial prescribed minute ventilation and post-resuscitation partial pressure of arterial carbon dioxide in patients with post-cardiac arrest syndrome. Annals of intensive care. 2014;4:. 13. Kim YJ, Lee YJ, Ryoo SM, Sohn CH, Ahn S, Seo DW, Lim KS, Kim WY. Role of blood gas analysis during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients. Medicine (Baltimore). 2016 Jun; 95(25): e3960. . 14. Kilgannon JH1, Jones AE, Shapiro NI, Angelos MG et al. Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. JAMA. 2010 Jun 2;303(21):2165-71. doi: 10.1001/jama.2010.707. 15. Prause G, Ratzenhofer-Comenda B, Smolle-Jüttner F,et al. Comparison of lactate or BE during out-of-hospital cardiac arrest to determine metabolic acidosis. Resuscitation. 2001 Dec;51(3):297-300. 16. Eastwood GM, Schneider AG, Suzuki S, Peck L, Young H, Tanaka A, et al. Targeted therapeutic mild hypercapnia after cardiac arrest: A phase II multi-centre randomised controlled trial (the CCC trial). Resuscitation. 2016;104:83-90. 17. Helmerhorst HJ, Roos-Blom MJ, van Westerloo DJ, Abu-Hanna A, de Keizer NF, de Jonge E. Associations of arterial carbon dioxide and arterial oxygen concentrations with hospital mortality after resuscitation from cardiac arrest. Crit Care. 2015;19:348. 18. Roberts BW, Kilgannon JH, Chansky ME, Mittal N, Wooden J, Trzeciak S. Association between postresuscitation partial pressure of arterial carbon dioxide and neurological outcome in patients with post cardiac arrest syndrome. Circulation. 2013 ve 127:2107-13. 19. Hazinski MF, Nolan JP, Billi JE, et al. Part 1: Executive Summary: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. In press. 20. Part 1: Executive Summary. 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015;132:S315-367. 21. Yundt KD, Diringer MN. The use of hyperventilation and its impact on cerebral ischemia in the treatment of traumatic brain injury. Crit Care Clin. 1997;13:163-84. 22. Roberts BW, Karagiannis P, Coletta M, Kilgannon JH, Chansky ME, Trzeciak S.Effects of PaCO2 derangements on clinical outcomes after cerebral injury: A systematic review. Resuscitation. 2015 Jun;91:32-41. doi: 10.1016/j.resuscitation.2015.03.015. Epub 2015. 23. Callaway CW, Donnino M, Fink E, Geocadin RG, Golan E, Kern KB, et al. Part 8: Post-cardiac arrest care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132:S465-S82. 24. Nolan JP, Hazinski MF, Aickin R, Bhanji F, Billi JE, Callaway CW, et al. Part 1: Executive summary: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation. 2015. 25. Eastwood GM, Tanaka A, Bellomo R. Cerebral oxygenation in mechanically ventilated early cardiac arrest survivors: The impact of hypercapnia. Resuscitation. 2016;102:11-6.
There are 1 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Surgical Science Research Articles |
| Authors | |
| Publication Date | October 27, 2020 |
| Acceptance Date | August 21, 2020 |
| Published in Issue | Year 2020Volume: 42 Issue: 3 |