The interaction between arterial oxygenation and carbon dioxide and hospital mortality following out of hospital cardiac arrest: a cohort study.

Critical Care : the Official Journal of the Critical Care Forum
Peter J McGuiganDanny F McAuley

Abstract

Outcomes following out of hospital cardiac arrest (OHCA) are poor. The optimal arterial oxygen and carbon dioxide (PaCO2) levels for managing patients following OHCA are unknown. We hypothesized that abnormalities in arterial oxygenation (PaO2/FiO2 ratio or PaO2) and PaCO2 would be associated with hospital mortality following OHCA. We hypothesized that PaCO2 would significantly modify the oxygenation-mortality relationship. This was an observational cohort study using data from OHCA survivors admitted to adult critical care units in England, Wales and Northern Ireland from 2011 to 2018. Logistic regression analyses were performed to assess the relationship between hospital mortality and oxygenation and PaCO2. The analysis included 23,625 patients. In comparison with patients with a PaO2/FiO2 > 300 mmHg, those with a PaO2/FiO2 ≤ 100 mmHg had higher mortality (adjusted OR, 1.79; 95% CI, 1.48 to 2.15; P < 0.001). In comparison to hyperoxemia (PaO2 > 100 mmHg), patients with hypoxemia (PaO2 < 60 mmHg) had higher mortality (adjusted OR, 1.34; 95% CI, 1.10 to 1.65; P = 0.004). In comparison with normocapnia, hypercapnia was associated with lower mortality. Hypocapnia (PaCO2 ≤ 35 mmHg) was associated with higher mortality (adjusted OR...Continue Reading

References

Jan 17, 1985·The New England Journal of Medicine·J M McCord
Nov 1, 1996·Intensive Care Medicine·G BuunkA E Meinders
Nov 17, 1998·American Journal of Respiratory and Critical Care Medicine·K ShibataB P Kavanagh
Dec 9, 2000·American Journal of Respiratory and Critical Care Medicine·J G LaffeyB P Kavanagh
Jan 4, 2001·Stroke; a Journal of Cerebral Circulation·C SundgreenJ Aldershvile
Aug 3, 2002·American Journal of Respiratory and Critical Care Medicine·Scott E SinclairMichael P Hlastala
Aug 26, 2003·Journal of Applied Physiology·Thomas F FloydRoderic G Eckenhoff
Dec 4, 2003·American Journal of Respiratory and Critical Care Medicine·John G LaffeyBrian P Kavanagh
Jul 9, 2005·Chest·Steve Iscoe, Joseph A Fisher
Mar 17, 2010·Critical Care Medicine·Gerard CurleyJohn G Laffey
Jun 3, 2010·JAMA : the Journal of the American Medical Association·J Hope KilgannonUNKNOWN Emergency Medicine Shock Research Network (EMShockNet) Investigators
Sep 23, 2010·Critical Care : the Official Journal of the Critical Care Forum·Laura C PriceStephen J Brett
Mar 10, 2011·Critical Care : the Official Journal of the Critical Care Forum·Rinaldo BellomoUNKNOWN Study of Oxygen in Critical Care (SOCC) Group
Dec 1, 2011·Intensive Care Medicine·Glenn EastwoodRichard Beasley
Jan 17, 2012·American Journal of Physiology. Lung Cellular and Molecular Physiology·Laura C PriceStephen John Wort
Jul 17, 2012·JAMA : the Journal of the American Medical Association·V Marco RanieriArthur S Slutsky
Jul 31, 2012·Resuscitation·Jimena Del CastilloUNKNOWN Iberoamerican Pediatric Cardiac Arrest Study Network RIBEPCI
Dec 29, 2012·Respiratory Care·Richard H Kallet, Michael A Matthay
May 4, 2013·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Annika NelskyläMarkus B Skrifvars
Nov 19, 2013·The New England Journal of Medicine·Niklas NielsenUNKNOWN TTM Trial Investigators
Dec 5, 2014·Intensive Care Medicine·Jonathan ElmerUNKNOWN Pittsburgh Post-Cardiac Arrest Service (PCAS)
Jun 11, 2015·The New England Journal of Medicine·Ingela Hasselqvist-AxLeif Svensson
Aug 19, 2015·Critical Care : the Official Journal of the Critical Care Forum·Hendrik J F HelmerhorstDavid J van Westerloo
Sep 30, 2015·Critical Care : the Official Journal of the Critical Care Forum·Hendrik J F HelmerhorstEvert de Jonge
Oct 3, 2015·BMJ Open·Gavin D PerkinsUNKNOWN OHCAO Project Group
Oct 3, 2015·American Journal of Epidemiology·Jonathan W BartlettJames R Carpenter
Oct 21, 2016·Critical Care Medicine·Hendrik J F HelmerhorstDavid J van Westerloo
Sep 6, 2017·Resuscitation·Henry E WangUNKNOWN Resuscitation Outcomes Consortium (ROC) Investigators

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