The Significance of Strong Ion Gap for Predicting Return of Spontaneous Circulation in Patients with Cardiopulmonary Arrest.
The Significance of Strong Ion Gap for Predicting Return of Spontaneous Circulation in Patients with Cardiopulmonary Arrest.
复制标题
DOI：
10.1515/med-2017-0006
复制
发表时间：
2017-01
期刊：
影响因子：
--
通讯作者：
Oshima K
中科院分区：
文献类型：
--
作者：
Kaneko M;Hagiwara S;Aoki M;Murata M;Nakajima J;Oshima K
预测心肺骤停(CPA)患者自主循环恢复(ROSC)的有用参数尚未建立。我们先前报告了根据到达医院时采集的血样计算的阴离子间隙(AG)和白蛋白校正的阴离子间隙(ACAG)对预测ROSC的有效性。此外，有报道称，强离子间隙(SIG)反映了血清中完全游离阳离子和阴离子水平的差异，有助于预测危重病患者的预后。这是一项前瞻性和观察性的临床研究。对2013年1月至2014年12月间转诊至本院急诊科的CPA患者进行评估。患者被分成两组：获得ROSC的患者[ROSC(+)组]和未获得ROSC(−)的患者。我们比较了两组之间的AG、ACAG和SIG。共有170名患者入选。50例患者纳入ROSC(+)组，其余120例纳入ROSC(−)组。ROSC(+)组AG和ACAG均明显好于ROSC(+)组，而SIG在两组间无显著差异。AG和ACAG的受试者工作特征曲线下面积(AUC)基本相同(分别为0.72和0.708)，SIG的AUC值(0.57)低于AG和ACAG。我们的结果表明，AG和ACAG比SIG更能预测心肺复苏(CPR)后的ROSC。
Useful parameters that can predict return of spontaneous circulation (ROSC) in patients with cardiopulmonary arrest (CPA) have not been established. We previously reported the usefulness of anion gap (AG) and albumin-corrected anion gap (ACAG) calculated from a blood sample obtained on arrival at the hospital for the prediction of ROSC. Otherwise, it has been reported that strong ion gap (SIG), which shows the difference between the levels of fully dissociated cations and anions in the serum, is useful to predict the prognosis of critically ill patients. This was a prospective and observational clinical study. Patients with CPA transferred to the emergency department of our hospital between January 2013 and December 2014 were evaluated. Patients were divided into two groups: patients who obtained ROSC [ROSC(+) group] and those who did not [ROSC(−) group]. We compared AG, ACAG and SIG between the two groups. A total of 170 patients were enrolled. Fifty patients were included in the ROSC(+) group, and the remaining 120 in the ROSC(−) group. Both AG and ACAG were significantly better in the ROSC(+) group; however, there was no significant difference in SIG between the two groups. The area under the receiver operating characteristic curves (AUC) for ROSC of both AG and ACAG were almost the same (0.72 and 0.708, respectively); the AUC of SIG (0.57) was inferior to those of AG and ACAG. Our results suggest that AG and ACAG can better predict ROSC following cardiopulmonary resuscitation (CPR) compared with SIG.