Exposure to high concentrations of inspired oxygen does not worsen lung injury after cardiac arrest

Critical Care : the Official Journal of the Critical Care Forum
Jonathan ElmerUniversity of Pittsburgh Post-Cardiac Arrest Service (PCAS)


Post-cardiac arrest patients are often exposed to 100% oxygen during cardiopulmonary resuscitation and the early post-arrest period. It is unclear whether this contributes to development of pulmonary dysfunction or other patient outcomes. We performed a retrospective cohort study including post-arrest patients who survived and were mechanically ventilated at least 24 hours after return of spontaneous circulation. Our primary exposure of interest was inspired oxygen, which we operationalized by calculating the area under the curve of the fraction of inspired oxygen (FiO₂AUC) for each patient over 24 hours. We collected baseline demographic, cardiovascular, pulmonary and cardiac arrest-specific covariates. Our main outcomes were change in the respiratory subscale of the Sequential Organ Failure Assessment score (SOFA-R) and change in dynamic pulmonary compliance from baseline to 48 hours. Secondary outcomes were survival to hospital discharge and Cerebral Performance Category at discharge. We included 170 patients. The first partial pressure of arterial oxygen (PaO₂):FiO₂ ratio was 241 ± 137, and 85% of patients had pulmonary failure and 55% had cardiovascular failure at presentation. Higher FiO₂AUC was not associated with change...Continue Reading


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Jun 1, 1988·Journal of Applied Physiology·Thomas R MartinJ M Drazen
Oct 1, 1988·Critical Care Medicine·V A Negovsky
Dec 31, 1970·The New England Journal of Medicine·R E Barber, W K Hamilton
Aug 26, 1998·Stroke; a Journal of Cerebral Circulation·Y LiuGary Fiskum
Aug 24, 2000·Epidemiology·J M RobinsB Brumback
Mar 23, 2004·Annals of the New York Academy of Sciences·Alessandra Pagano, Constance Barazzone-Argiroffo
Aug 13, 2004·The New England Journal of Medicine·Ian G StiellOntario Prehospital Advanced Life Support Study Group
Sep 15, 2004·Intensive Care Medicine·Stephen LaverJerry Nolan
Dec 16, 2004·Critical Care Medicine·Scott E SinclairEmil Y Chi
Sep 9, 2005·American Journal of Physiology. Lung Cellular and Molecular Physiology·Monique E De PaepeSurendra Sharma
Oct 28, 2005·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Viktoria VereczkiGary Fiskum
Jan 2, 2007·Current Opinion in Critical Care·William A Altemeier, Scott E Sinclair
May 30, 2008·Frontiers in Bioscience : a Journal and Virtual Library·Vineet Bhandari
Jul 3, 2008·Intensive Care Medicine·Stephen TrzeciakMicrocirculatory Alterations in Resuscitation and Shock (MARS) investigators
Jul 16, 2008·American Journal of Physiology. Lung Cellular and Molecular Physiology·Gustavo Matute-BelloThomas R Martin
Oct 28, 2008·Resuscitation·Jon C RittenbergerClifton W Callaway
Dec 4, 2008·Critical Care Medicine·Jérôme Allardet-ServentLaurent Papazian
Oct 21, 2009·Translational Research : the Journal of Laboratory and Clinical Medicine·Yung-Yang LiuLi-Fu Li
Jan 16, 2010·Journal of Aerosol Medicine and Pulmonary Drug Delivery·Elizabeth R Johnson, Michael A Matthay
Jun 3, 2010·JAMA : the Journal of the American Medical Association·J Hope KilgannonEmergency Medicine Shock Research Network (EMShockNet) Investigators
Sep 30, 2010·Intensive Care Medicine·Aafke Elizabeth de GraaffEvert de Jonge
Mar 10, 2011·Critical Care : the Official Journal of the Critical Care Forum·Rinaldo BellomoStudy of Oxygen in Critical Care (SOCC) Group
May 25, 2011·Circulation·J Hope KilgannonEmergency Medicine Shock Research Network (EMShockNet) Investigators
Jul 16, 2011·Resuscitation·Jon C RittenbergerClifton W Callaway
Dec 20, 2011·Circulation·Véronique L RogerAmerican Heart Association Statistics Committee and Stroke Statistics Subcommittee
Mar 20, 2013·Critical Care Medicine·Brian W RobertsStephen Trzeciak
Sep 26, 2013·Oxidative Medicine and Cellular Longevity·Kenji DohiTohru Aruga
Dec 5, 2014·Intensive Care Medicine·Jonathan ElmerPittsburgh Post-Cardiac Arrest Service (PCAS)

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