Optimal Arterial Blood Gas Tensions for the Prognosis of Favorable Neurological Outcomes in Survivors After Extracorporeal Cardiopulmonary Resuscitation

Overview

Journal J Clin Med

Specialty General Medicine

Date 2022 Jul 27

PMID 35887974

Authors

Sungmin Hong

Ji Hoon Jang

Jeong Hoon Yang

Yang Hyun Cho

Joonghyun Ahn

Jeong-Am Ryu

Affiliations

Soon will be listed here.

Abstract

Our aim is to assess the optimal levels of oxygen and carbon dioxide for the prognosis of favorable neurologic outcomes in survivors after extracorporeal cardiopulmonary resuscitation (ECPR). We obtained the mean levels of PaCO and PaO in arterial blood gas samples 72 h after ECPR. The primary outcome was the neurological status, according to the Cerebral Performance Categories (CPC) scale, upon discharge. Of 119 (48.6%) survivors, 95 (38.8%) had favorable neurologic outcomes (CPC 1 or 2). There was a U-shaped relationship between mean arterial blood gas tensions and poor neurological outcomes. The risk of poor neurological outcome was lowest in patients with the second tertile of mean PaCO (30-42 mm Hg) and PaO (120-160 mm Hg). In a multivariable analysis, third tertile of mean PaCO, third tertile of mean PaO, age, shockable rhythm, out of hospital cardiac arrest, duration of cardiopulmonary resuscitation, and ECPR at cardiac catheterization lab were found to be significantly associated with poor neurologic outcomes. Additionally, hypercapnia and extreme hyperoxia were found to be significantly associated with poor neurological outcomes after ECPR. Therefore, maintaining adequate arterial levels of oxygen and carbon dioxide may be important for favorable neurological prognoses in survivors after ECPR.

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