Low hemoglobin levels are associated with lower cerebral saturations and poor outcome after cardiac arrest

Resuscitation
K AmelootC De Deyne

Abstract

Post-cardiac arrest (CA) patients have a large cerebral penumbra at risk for secondary ischemic damage in case of suboptimal brain oxygenation during ICU stay. The aims of this study were to investigate the association between hemoglobin, cerebral oxygenation (SctO2) and outcome in post-CA patients. Prospective observational study in 82 post-CA patients. Hemoglobin, a corresponding SctO2 measured by NIRS and SVO2 in patients with a pulmonary artery catheter (n=62) were determined hourly during hypothermia in the first 24h of ICU stay. We found a strong linear relationship between hemoglobin and mean SctO2 (SctO2=0.70×hemoglobin+56 (R(2) 0.84, p=10(-6))). Hemoglobin levels below 10g/dl generally resulted in lower brain oxygenation. There was a significant association between good neurological outcome (43/82 patients in CPC 1-2 at 180 days post-CA) and admission hemoglobin above 13g/dl (OR 2.76, 95% CI 1.09:7.00, p=0.03) or mean hemoglobin above 12.3g/dl (OR 2.88, 95%CI 1.02:8.16, p=0.04). This association was entirely driven by results obtained in patients with a mean SVO2 below 70% (OR 6.25, 95%CI 1.33:29.43, p=0.01) and a mean SctO2 below 62.5% (OR 5.87, 95%CI 1.08:32.00, p=0.03). Hemoglobin levels below 10g/dl generally resul...Continue Reading

References

Oct 1, 1992·Stroke; a Journal of Cerebral Circulation·K Korosue, R C Heros
Mar 1, 1992·Annals of Internal Medicine·H G WelchL T Goodnough
Jan 1, 1990·Scandinavian Journal of Clinical and Laboratory Investigation. Supplementum·A Coetzee, C Swanepoel
Oct 30, 2001·The New England Journal of Medicine·W C WuH M Krumholz
May 3, 2003·Journal of Clinical Epidemiology·Vincent de GrootLex M Bouter
Oct 7, 2004·JAMA : the Journal of the American Medical Association·Sunil V RaoRobert M Califf
May 14, 2005·Critical Care Medicine·Michelle J SmithPeter D Le Roux
Sep 13, 2006·The Journal of Trauma·Andrew P CarlsonStephen W Lu
Jun 9, 2007·Journal of Applied Physiology·Gregory M T HareAndrew J Baker
Oct 18, 2007·Proceedings of the National Academy of Sciences of the United States of America·James D ReynoldsJonathan S Stamler
Aug 6, 2008·Critical Care Medicine·Paul E Marik, Howard L Corwin
Aug 30, 2008·Journal of the American College of Surgeons·Ali SalimDaniel R Margulies
Mar 12, 2009·The Journal of Trauma·Humberto K TangoJosé O C Auler
Feb 2, 2010·Journal of Neurosurgery·Matthew A WarnerRamon Diaz-Arrastia
Jun 7, 2011·The American Journal of Emergency Medicine·UNKNOWN SOS-KANTO study group
Dec 16, 2011·The New England Journal of Medicine·Jeffrey L CarsonUNKNOWN FOCUS Investigators
May 16, 2012·Intensive Care Medicine·Mauro OddoPeter D Le Roux
Jul 24, 2012·Critical Care : the Official Journal of the Critical Care Forum·Mypinder S SekhonDonald E G Griesdale
Jan 4, 2013·The New England Journal of Medicine·Càndid VillanuevaCarlos Guarner
Oct 2, 2014·The New England Journal of Medicine·Paul C Hébert, Jeffrey L Carson
Dec 24, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Marco SteinMatthias F Oertel
Mar 12, 2015·The New England Journal of Medicine·Gavin J MurphyUNKNOWN TITRe2 Investigators
Jul 15, 2015·The New England Journal of Medicine·Barnaby C ReevesGavin J Murphy
Aug 29, 2016·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Zachariah DeFilipp, Yi-Bin Chen

❮ Previous
Next ❯

Citations

May 18, 2016·Critical Care : the Official Journal of the Critical Care Forum·Koen AmelootMatthias Dupont
Jun 18, 2016·Critical Care : the Official Journal of the Critical Care Forum·Christophe LelubreFabio Silvio Taccone
Nov 5, 2016·Journal of Critical Care·Nicholas J JohnsonAnne V Grossestreuer
Apr 14, 2017·Critical Care : the Official Journal of the Critical Care Forum·Mypinder S SekhonDonald E Griesdale
Sep 11, 2020·Transfusion Medicine Reviews·Philip Crispin, Kathryn Forwood

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.

Anemia

Anemia develops when your blood lacks enough healthy red blood cells. Anemia of inflammation (AI, also called anemia of chronic disease) is a common, typically normocytic, normochromic anemia that is caused by an underlying inflammatory disease. Here is the latest research on anemia.

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.