Abstract 198: Neither Hypoxia Nor Hyperoxia Is Associated with Mortality in a Cohort of Postarrest Patients
Introduction: During and after resuscitation from cardiac arrest, patients often receive supplemental oxygen with high FiO2. Recent human data suggest that arterial hyperoxia is associated with worse outcomes.
Hypothesis: Neurologically intact survivors are more likely to be normoxic rather than hypoxic or hyperoxic.
Methods: This was a retrospective chart review of 111 post-arrest patients treated with therapeutic hypothermia, hemodynamic optimization, and other aspects of modern critical care, who were prospectively enrolled in a multicenter clinical study examining mitochondrial dysfunction from ischemia-reperfusion injury (COMICA Study Group). Demographic variables were analyzed using chi-square tests. Comparisons of means were completed using a students t-test. Logistic regression analyses were performed to assess the relationship between hypoxia (PaO2 300 mm Hg), mortality, and neurologic outcomes.
Results: Patients were 61± 16.8 years, 59.5% male, and had an initial rhythm of VF/VT in 50.5% of cases. We found the vast majority of patients in this study had PaO2 values in the optimal range at all time points (79% 0 hr; 95% 12 hrs; 92% 24 hrs; 95% 36 hrs; 93% 48 hrs) and no differences between mean values for survivors and non-survivors (see Table 1) or those with good vs. poor neurologic outcomes. Logistic regression did not yield any statistically significant results when controlling for gender and initial rhythm.
Conclusions: In a cohort of patients enrolled in a multi-center study of post-arrest mitochondrial dysfunction, we found that the vast majority of patients had arterial oxygen levels optimized rapidly after ROSC and no differences in mean PaO2 levels between survivors and non-survivors or those with good vs. poor neurologic outcomes. At high-volume centers using protocol-driven post-arrest care, optimal PaO2 levels can be achieved in the majority of patients rapidly after ROSC.
- © 2012 by American Heart Association, Inc.