Purpose: This study evaluated the role of point-of-care tests (POCT) like blood lactate, anion gap, base deficit, pH, N-terminal pro B-type natriuretic peptide (NT-proBNP), and troponin as predictors of cardiac arrest outcomes in the emergency department (ED).
Methods: We conducted a prospective, observational study in the ED of a tertiary care hospital in India. All the adult patients who received cardiopulmonary resuscitation (CPR) in the ED were included in the study. Blood samples were collected within 10 minutes of initiation of CPR for assay of POCTs. Outcomes assessed were the return of spontaneous circulation (ROSC), 24-hour survival, survival to hospital discharge (STHD), survival at 7-days, and favorable neurological outcome (FNO) at day-7 of admission.
Results: One hundred fifty-one patients were included in the study (median age - 50years, 65% males). Out of 151 cases, ROSC, survival at 7-days, STHD, and FNO was observed in 86 patients, six patients, five patients and two patients, respectively. 'No-ROSC' could be significantly predicted by raised lactate (odds ratio, OR: 1.14, 95%CI: 1.07–1.22) and NT-proBNP (OR: 1.05, 1.01–1.09) values at the time of cardiac arrest. ‘24-hour mortality’ could be significantly predicted by the raised lactate (OR: 1.14, 1.01–1.28), low arterial pH (OR: 0.05, 0.01–0.52), raised AG (OR: 1.08, 1.01–1.15), and increased base deficit (OR: 1.07, 1.01–1.14). None of the other POCTs was found to be a predictor of other cardiac arrest outcomes.
Conclusion: Among various POCTs, raised lactate assayed within 10 minutes of cardiac arrest can predict poor outcomes like 'no-ROSC' and 24-hour mortality.

Emergency Department Point-of-Care Tests during Cardiopulmonary Resuscitation to Predict Cardiac Arrest Outcomes

Implementation of the Guidelines - How do we put the new ERC Guidelines into practice?

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