In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 138, No. Suppl_2 ( 2018-11-06)
Abstract:
Background: The effect of hyperoxia for outcomes in resuscitated patients with out-of-hospital cardiac arrest (OHCA) is still controversial. Objective: To assess the relationship between the post-ROSC hyperoxia exposure volume (HEV) and survival among resuscitated OHCA patients. Methods: The JAAM-OHCA Registry was a multicenter prospective observation using the OHCA database obtained from 73 critical care medical centers in Japan, and the study period were between June 2014 and December 2015. In this study, patients who sustained a cardiac arrest in a prehospital setting, for whom resuscitation was attempted, and who were then transported to participating institutions were included. Patients receiving extracorporeal cardiopulmonary resuscitation and who was dead in emergency room were excluded. Arterial blood gases were sampled on hospital arrival, ROSC, ICU admission, and at least 24-hours post-ROSC. In addition to the 4 sampling times mentioned above, arterial blood gases were sampled, as and when required. Hyperoxia was defined as a PaO2 value of 〉 =300 mm Hg. Hyperoxia exposure time (HET) was defined as the time of a sustained PaO2 value of 〉 =300 mmHg, and hyperoxia excess level (HEL) was defined as the highest PaO2 level from hospital arrival to 24-hours post-ROSC. HEV was calculated by HET*HEV/2. Primary outcome was one-month survival. Multivariable logistic regression adjusting for age, sex, initial shockable rhythm, bystander witness, bystander CPR, time from call to hospital arrival, tracheal intubation, and targeted temperature management was performed to assess the association between HEV and survival. Results: A total of 1751 patients were included and 414 (23.6%) had hyperoxia. Among the hyperoxia patients, survival gradually decreased from 50.0% to 44.2% as HEV increased. The adjusted odds ratio of minimum HEV groups or maximum HEV groups for one-month survival compared with non-hyperoxia group was 2.50 (95% confidence interval [CI], 1.33-4.70 ) and 1.16 (95% CI, 0.62-2.18), respectively. Conclusions: Among resuscitated OHCA patients, excessive amounts of HEV was associated with decreased one-month survival.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.138.suppl_2.275
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2018
detail.hit.zdb_id:
1466401-X
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