• Chin-Fu Chang, Chao-Jui Li, Chih-Jan Ko, Tsung-Han Teng, Shih-Chang Lai, Mei-Chueh Yang, Chun-Wen Chiu, Chu-Chung Chou, Chih-Yu Chang, Yung-Chiao Yao, Lan-Hsin Wu, Han-Ping Wu, Wen-Liang Chen, and Yan-Ren Lin.
• Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan.
• Plos One. 2013 Jan 1;8(10):e75172.

ObjectiveTo analyze whether urine output and urinalysis results are predictive of survival and neurologic outcomes in patients with non-traumatic out-of-hospital cardiac arrest (OHCA).MethodsInformation was obtained from 1,340 patients with non-traumatic OHCA who had achieved a sustained return of spontaneous circulation (ROSC). Factors that were associated with survival in the post-resuscitative period were evaluated. The association between urine output and fluid challenge in the early resuscitative period was analyzed and compared between the survivors and the non-survivors. The results of the initial urinalysis, including the presence of proteinuria and other findings, were used to evaluate the severity of vascular protein leakage and survival. The association between proteinuria and the neurologic outcomes of the survivors was also analyzed. The clinical features of capillary leakage were examined during the post-resuscitative period.ResultsOf the 1,340 patients, 312 survived. A greater urine output was associated with a higher chance of survival. The initial urine output increased in proportion to the amount of fluid that was administered during early resuscitation in the emergency department for the survivors but not for the non-survivors (p<0.05). In the initial urinalysis, proteinuria was strongly associated with survival, and severe proteinuria indicated significantly poorer neurologic outcomes (p<0.05 for both comparisons). Proteinuria was associated with a risk of developing signs of capillary leakage, including body mass index gain and pitting edema (both p<0.001).ConclusionThe severity of proteinuria during the early post-resuscitative period was predictive of survival.

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