Hyperoxia is associated with increased mortality in patients treated with mild therapeutic hypothermia after sudden cardiac arrest.
Hyperoxia is associated with increased mortality in patients treated with mild therapeutic hypothermia after sudden cardiac arrest.
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DOI：
10.1097/ccm.0b013e3182656976
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发表时间：
2012-12
影响因子：
8.8
通讯作者：
Rice TW
中科院分区：
文献类型：
--
作者：
Janz DR;Hollenbeck RD;Pollock JS;McPherson JA;Rice TW
确定较高水平的动脉血氧分压是否与心脏骤停后接受轻度治疗性低温治疗的患者出院时的院内死亡率和神经功能状态不良相关。前瞻性队列研究的回顾性分析在一家学术性三级护理医院的心血管护理病房中，共有170名连续患者接受了治疗性低温治疗。没有。170例患者中，77例（45.2%）存活出院。在心脏骤停后的前24小时内，存活者的最大动脉血氧分压（198 mmHg，IQR 152.5-282）显著低于非存活者（254 mmHg，IQR 172-363，p = 0.022）。一项多变量分析包括年龄、自主循环恢复时间、休克的存在、旁观者CPR和初始心律，显示较高水平的动脉血氧分压与院内死亡率增加显著相关（比值比1.439，95%置信区间1.028-2.015，p = 0.034）和出院时神经系统状态差（比值比1.485，95%置信区间1.032-2.136，p = 0.033）。在心脏骤停后接受轻度低温治疗的患者中，较高水平的最大动脉血氧分压与院内死亡率增加和出院时神经功能状态不良相关。
To determine if higher levels of partial pressure of arterial oxygen are associated with in-hospital mortality and poor neurologic status at hospital discharge in patients treated with mild therapeutic hypothermia after sudden cardiac arrest. Retrospective analysis of a prospective cohort study A total of 170 consecutive patients treated with therapeutic hypothermia in the cardiovascular care unit of an academic tertiary care hospital. None. Of 170 patients, 77 (45.2%) survived to hospital discharge. Survivors had a significantly lower maximum partial pressure of arterial oxygen(198 mmHg, IQR 152.5–282) measured in the first 24 hours following cardiac arrest compared to nonsurvivors (254 mmHg, IQR 172–363, p = .022). A multivariable analysis including age, time to return of spontaneous circulation, the presence of shock, bystander CPR, and initial rhythm revealed that higher levels of the partial pressure of arterial oxygen were significantly associated with increased in-hospital mortality (odds ratio 1.439, 95% confidence interval 1.028–2.015, p = 0.034) and poor neurologic status at hospital discharge (odds ratio 1.485, 95% confidence interval 1.032–2.136, p = 0.033). Higher levels of the maximum measured partial pressure of arterial oxygen are associated with increased in-hospital mortality and poor neurologic status on hospital discharge in patients treated with mild therapeutic hypothermia after sudden cardiac arrest.