• Resuscitation · May 2017

    Multicenter Study

    Initial arterial carbon dioxide tension is associated with neurological outcome after resuscitation from cardiac arrest.

    • Molly L Tolins, Daniel J Henning, David F Gaieski, Anne V Grossestreuer, Alison Jaworski, and Nicholas J Johnson.
    • Division of Emergency Medicine, Department of Medicine, University of Washington, Seattle WA, United States. Electronic address: mol.tolins@gmail.com.
    • Resuscitation. 2017 May 1; 114: 53-58.

    Study ObjectivesTo determine the relationships between partial pressure of arterial carbon dioxide (PaCO2), prescribed minute ventilation (MV), and neurologic outcome in patients resuscitated from cardiac arrest.MethodsThis was a retrospective cohort study utilizing a multicenter database of adult patients with return of spontaneous circulation (ROSC) after cardiac arrest. The primary outcome was neurologic status at hospital discharge, defined by Cerebral Performance Category (CPC) score: CPC 1-2 was favorable, CPC 3-5 was poor. We compared rates of initial normocarbia (PaCO231-49mmHg) and mean sequential PaCO2measurements obtained over the first 24h. We also assessed the influence of MV on the PaCO2at initial, 6, 12, 18, and 24h after cardiac arrest using univariate linear regression.ResultsOne hundred and fourteen patients from 3 institutions met inclusion criteria. Overall, 46/114 (40.4%, 95% CI: 31.4-49.4%) patients survived to hospital discharge, and 33/114 (28.9%, 20.6-37.2%) had CPC 1-2 at the time of discharge. A total of 38.9% (95% CI: 29.9-47.9%) of patients had initial normocarbia; 43.2% (28.6-57.8%) of these patients were discharged with CPC 1-2, compared with 20.3% (10.8-29.8%) of dyscarbic patients. By 6h, neurologic outcomes were not significantly associated with PaCO2. Prescribed MV was not associated with PaCO2at any time point with the exception of a weak correlation at hour 18.ConclusionInitial normocarbia was associated with favorable neurological outcome in patients resuscitated from cardiac arrest. This relationship was not seen at subsequent time points. There was no significant association between prescribed MV and PaCO2or neurologic outcome.Copyright © 2017 Elsevier B.V. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…