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Sep 13, 2018

ERC congress - Resuscitation 2018

3 - Early hyperoxia does not compromise the long-term neurological outcome after cardiopulmonary resuscitation

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Abstract

Introduction Numerous studies suggest hyperoxia increases short-term mortality after cardiopulmonary resuscitation (CPR), but data on long-term mortality and neurological outcome are scarce. (1-4) We determined whether early hyperoxia after CPR is associated with long-term neurological outcome. Methods Data from adult cardiac arrest patients treated after CPR in Meilahti University hospital intensive care units between years 2005 and 2013 were analysed retrospectively. Initial arterial PaO2 was determined from the first arterial blood sample collected after resuscitation. Hyperoxia was defined PaO2 >16 kPa and hypoxia PaO2 <8 kPa. Other variables included in the analyses were age, vital signs, PaCO2 and pH, laboratory parameters (lactate, creatinine, Hb, plasma glucose), cardiac arrest location and initial rhythm. The primary outcome was Cerebral Performance Category 12 months after the resuscitation. We categorised scores 1 and 2 as “favourable neurological outcome” and 3 or greater as “unfavourable neurological outcome”. We performed univariate and multiple logistic regression to test associations between variables and the outcome. Results Study population included 925 patients. According to univariate analysis hyperoxia was associated with lower risk of unfavourable neurological outcome (odds ratio [OR] 0.61: 95% confidence interval [CI] 0.43-0.87, p=0.006) compared to normoxia. However, this association disappeared after the adjustment for confounding variables (OR 0.75: 95% CI 0.47-1.20), p=0.23). Additionally, there was a significant association between unfavourable neurological outcome and higher age (OR 1.02: 95% CI 1.01-1.03), p<0.001) and higher lactate concentration (OR 1.09: 95% CI 1.04-1.14), p<0,001). Compared to ventricular fibrillation the risk of unfavourable neurological outcome was higher for asystole (OR 2.32: 95% CI 1.40-3.85), p=0.001) and pulseless electrical activity (OR 1.81: 95% CI 1.22-2.66), p=0.003). Conclusions Our study showed no association between early post-arrest hyperoxia and unfavourable neurological outcome. The impact of hyperoxia on neurological long-term outcome needs further study.

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© Copyright 2019 Morressier GmbH.
All rights reserved.