The association between hyperoxia and patient outcomes after cardiac arrest: analysis of a high-resolution database

Intensive Care Medicine
Jonathan ElmerPittsburgh Post-Cardiac Arrest Service (PCAS)

Abstract

Previous observational studies have inconsistently associated early hyperoxia with worse outcomes after cardiac arrest, and have methodological limitations. We tested this association using a high-resolution database controlling for multiple disease-specific markers of severity of illness and care processes. This was a retrospective analysis of a single-center, prospective registry of consecutive cardiac arrest patients. We included patients who survived and were mechanically ventilated ≥24 h after arrest. Our main exposure was arterial oxygen tension (PaO2), which we categorized hourly for 24 h as severe hyperoxia (>300 mmHg), moderate or probable hyperoxia (101-299 mmHg), normoxia (60-100 mmHg) or hypoxia (<60 mmHg). We controlled for Utstein-style covariates, markers of disease severity and markers of care responsiveness. We performed unadjusted and multiple logistic regression to test the association between oxygen exposure and survival to discharge, and used ordered logistic regression to test the association of oxygen exposure with neurological outcome and Sequential Organ Failure Assessment (SOFA) score at 24 h. Of 184 patients, 36 % were exposed to severe hyperoxia and overall mortality was 54 %. Severe hyperoxia, but n...Continue Reading

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Related Concepts

Oxygen Measurement, Partial Pressure, Arterial
Hospital Mortality
Hyperoxia
Intensive Care Unit
Observation - Diagnostic Procedure
Single Organ Dysfunction
Hypoxia
Mechanical Ventilation
Retrospective Studies
Survival Rate

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