| Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | |
| Prevalence and factors correlating with hyperoxia exposure following cardiac arrest – an observational single centre study | |
| Markus B Skrifvars2  Michael J Parr1  Annika Nelskylä2  | |
| [1] University of New South Wales, Sydney, Australia;Department of Anaesthesiology and Intensive Care, Helsinki University Central Hospital, University of Helsinki, Topeliuksenkatu 5, PL 266, Helsinki, Finland | |
| 关键词: Mechanical ventilation; Hyperoxia; Cardiac arrest; | |
| Others : 811206 DOI : 10.1186/1757-7241-21-35 |
|
| received in 2013-01-14, accepted in 2013-04-25, 发布年份 2013 | |
PDF
|
|
【 摘 要 】
Purpose of the study
Arterial hyperoxia during care in the intensive care unit (ICU) has been found to correlate with mortality after cardiac arrest (CA). We examined the prevalence of hyperoxia following CA including pre-ICU values and studied differences between those exposed and those not exposed to define predictors of exposure.
Materials and methods
A retrospective analysis of a prospectively collected cohort of cardiac arrest patients treated in an Australian tertiary hospital between August 2008 and July 2010. Arterial blood oxygen values and used fractions of oxygen were recorded during the first 24 hours after the arrest. Hyperoxia was defined as any arterial oxygen value greater than 300 mmHg. Chi-square test was used to compare categorical data and Mann–Whitney U-test to continuous data. Statistical methods were used to identify predictors of hyperoxia exposure.
Results
Of 122 patients treated in the ICU following cardiac arrest 119 had one or several arterial blood gases taken and were included in the study. Of these, 49 (41.2%) were exposed to hyperoxia and 70 (58.8%) were not during the first 24 hours after the CA. Those exposed had longer delays to return of spontaneous circulation (26 minutes vs. 10 minutes) and a longer interval to ICU admission after the arrest (4 hours compared to 1 hour). Location of the arrest was an independent predictor of exposure to hyperoxia (P-value = 0,008) with out-of-hospital cardiac arrest patients being more likely to have been exposed (65%), than those with an in-hospital (21%) or ICU (30%) cardiac arrest. Out-of-hospital cardiac arrest patients had higher oxygen concentrations to the fraction of inspired oxygen ratios.
Conclusions
Hyperoxia exposure was more common than previously reported and occurred more frequently in association with out-of-hospital cardiac arrest, longer times to ROSC and delays to ICU admission.
【 授权许可】
2013 Nelskylä et al.; licensee BioMed Central Ltd.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20140709061531188.pdf | 185KB | ||
| Figure 1. | 38KB | Image |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Peberdy MA, Kaye W, Ornato JP, Larkin GL, Nadkarni V, Mancini ME, Berg RA, Nichol G, Lane-Trultt T: Cardiopulmonary resuscitation of adults in the hospital: a report of 14 720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation 2003, 58:297-308.
- [2]Stiell IG, Wells GA, Field B, Spaite DW, Nesbitt LP, De Maio VJ, Nichol G, Cousineau D, Blackburn J, Munkley D, Luinstra-Toohey L, Campeau T, Dagnone E, Lyver M: Advanced cardiac life support in out-of-hospital cardiac arrest. N Engl J Med 2004, 351(7):647-656.
- [3]Nolan JP, Neumar RW, Adrie C, Aibiki M, Berg RA, Böttiger BW, Callaway C, Clark RSB, Geocadin RG, Jauch EC, Kern KB, Laurent I, Longstreth WT, Merchant RM, Morley P, Morrison LJ, Nadkarni V, Perberdy MA, Rivers EP, Rodriguez-Nunez , Sellke FW, Spaulding C, Sunde K, Vanden Hoek T: Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A scientific statement from the International Liaison Committee on Resuscitation; the American Heart Association emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Cinical Cardiology; the Council on Stroke. Resuscitation 2008, 79:350-379.
- [4]Zeiner A, Holzer M, Sterz F, Schörkhuber W, Eisenburger P, Havel C, Kliegel A, Laggner AN: Hyperthermia after cardiac arrest is associated with an unfavorable neurologic outcome. Arch Intern Med 2001, 161:2007-2012.
- [5]Müllner M, Sterz F, Binder M, Schreiber W, Deimel A, Laggner AN: Blood glucose concentration after cardiopulmonary resuscitation influences functional neurological recovery in human cardiac arrest survivors. J Cereb Blood Flow Metab 1997, 17:430-436.
- [6]Zhou Q, Cao B, Niu L, Cui X, Yu H, Liu J, Li H, Li W: Effects of permissive hypercapnia on transient global cerebral ischemia–reperfusion injury in rats. Anesthesiology 2010, 112:288-297.
- [7]Kilgannon JH, Jones AE, Shapiro NI, Angelos MG, Milcarek B, Hunter K, Parrillo JE, Trzeciak S: Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. JAMA 2010, 303:2165-2171.
- [8]Bellomo R, Bailey M, Eastwood GM, Nichol A, Pilcher D, Hart GK, Reade MC, Egi M, Cooper J: Arterial hyperoxia and in-hospital mortality after resuscitation from cardiac arrest. Crit Care 2011, 15:R90. BioMed Central Full Text
- [9]Skrifvars MB, Varghese B, Parr MJ: Survival and outcome prediction using the Apache III and the out-of-hospital cardiac arrest (OHCA) score in patients treated in the intensive care unit (ICU) following out-of-hospital, in-hospital or ICU cardiac arrest. Resuscitation 2012, 83:728-733.
- [10]Peberdy MA, Callaway CW, Neumar RW, Geocadin RG, Zimmerman JL, Donnino M, Gabrielli A, Silvers SM, Zaritsky AL, Merchant R, Vanden Hoek TL, Kronick SL: Part 9: Post-Cardiac arrest care: 2010 American Heart Association Guidelines for Cardiopulmonary resuscitation and Emergency Cardiovascular care. Circulation 2010, 2010(122):768-786.
- [11]Langhelle A, Nolan J, Herlitz J, Castren M, Wenzel V, Soreide E, Engdahl J, Steen PA: Recommended guidelines for reviewing, reporting and conducting research on post-resuscitaion care: the Utstein style. Resuscitation 2005, 66:271-283.
- [12]del Castillo J, Lopéz-Herce J, Matamoros M, Canadas S, Rodrigues-Calvo , Cechetti C, Rodriguez-Nunez A, Alvarez AC: Hyperoxia, hypocapnia and hypercapnia as outcome factors after cardiac arrest in children. Resuscitation 2012, 83:1456-1461.
- [13]Janz DR, Hollenbeck RD, Pollock JS, McPherson JA, Rice TW: Hyperoxia is associated with increased mortality in patients treated with mild therapeutic hypothermia after sudden cardiac arrest. Crit Care Med 2012, 40:3135-3139.
- [14]Deulofeut R, Critz A, Adams-Chapman I, Sola A: Avoiding hyperoxia in infants ≤ 1259g is associated with improved short- and long-term outcomes. J Perinatol 2006, 26:700-705.
- [15]Chen J, Smith LE: Retinopathy of prematurity. Angiogenesis 2007, 10:133-140.
- [16]Smith GB, Prytherch DR, Watson D, Forde V, Windsorf A, Schmidt PE, Featherstone PI, Higgins B, Meredith P: Sp02 values in acute medical admissions breathing air- Implications for the British Thoracic Society guideline for emergency oxygen use in adult patients? Resuscitation 2012, 83:1201-1205.
- [17]Parnia S, Nasir A, Shah C, Patel R, Mani A, Richman P: A feasibility study evaluating the role of cerebral oximetry in predicting return of spontaneous circulation in cardiac arrest. Resuscitation 2012, 83:982-985.
- [18]Newman DH, Callaway CW, Greenwald IB, Freed J: Cerebral oximetry in out-of-hospital cardiac arrest: standard CPR rarely provides detectable hemoglobin–oxygen saturation to the frontal cortex. Resuscitation 2004, 64:189-194.
- [19]Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, Smith K: Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002, 346:557-563.
- [20]Bandali KS, Belanger MP, Wittnich C: Is hyperglycemia seen in children during cardiopulmonary bypass as a result of hyperoxia? J Thorac Cardiovasc Surg 2001, 122:753-758.
- [21]Bandali KS, Belanger MP, Wittnich C: Does hyperoxia affect glucose regulation and transport in the newborn? J Thorac Cardiovasc Surg 2003, 126:1730-1735.
PDF