TY  - BOOK
AU  - Goyal, Munish
TI  - The Association Between Arterial Oxygen Tension and Neurological Outcome After Cardiac Arrest
SN  - 2153-7658
PY  - 2017///
KW  - *Heart Arrest/bl [Blood]
KW  - *Heart Arrest/pp [Physiopathology]
KW  - *Nervous System/pp [Physiopathology]
KW  - *Oxygen/bl [Blood]
KW  - Adult
KW  - Aged
KW  - Aged, 80 and over
KW  - Biomarkers/bl [Blood]
KW  - Female
KW  - Heart Arrest/mo [Mortality]
KW  - Heart Arrest/th [Therapy]
KW  - Hospital Mortality
KW  - Humans
KW  - Hyperoxia/bl [Blood]
KW  - Hyperoxia/mo [Mortality]
KW  - Hyperoxia/pp [Physiopathology]
KW  - Hypothermia, Induced
KW  - Hypoxia/bl [Blood]
KW  - Hypoxia/mo [Mortality]
KW  - Hypoxia/pp [Physiopathology]
KW  - Male
KW  - Middle Aged
KW  - Partial Pressure
KW  - Recovery of Function
KW  - Registries
KW  - Respiration, Artificial
KW  - Resuscitation/mt [Methods]
KW  - Retrospective Studies
KW  - Risk Factors
KW  - Time Factors
KW  - Treatment Outcome
KW  - United States
KW  - MedStar Washington Hospital Center
KW  - Emergency Medicine
KW  - Journal Article
N2  - A number of observational studies have evaluated the association between arterial oxygen tensions and outcome after cardiac arrest with variable results. The objective of this study is to determine the association between arterial oxygen tension and neurological outcome after cardiac arrest. A retrospective cohort analysis was performed using the Penn Alliance for Therapeutic Hypothermia registry. Adult patients who experienced return of spontaneous circulation after in-hospital or out-of-hospital cardiac arrest (OHCA) and had a partial pressure of arterial oxygen (PaO<sub>2</sub>) recorded within 48 hours were included. Our primary exposure of interest was PaO<sub>2</sub>. Hyperoxemia was defined as PaO<sub>2</sub> > 300mmHg, hypoxemia as PaO<sub>2</sub> < 60mmHg, and optimal oxygenation as PaO<sub>2</sub> 60-300mmHg. The primary outcome was neurological function at hospital discharge among survivors, as described by the cerebral performance category (CPC) score, dichotomized into "favorable" (CPCs 1-2) and "unfavorable" (CPCs 3-5). Secondary outcomes included in-hospital mortality. A total of 544 patients from 13 institutions were included. Average age was 61 years, 56% were male, and 51% were white. A total of 64% experienced OHCA, 81% of arrests were witnessed, and pulseless electrical activity was the most common initial rhythm (40%). More than 72% of the patients had cardiac etiology for their arrests, and 55% underwent targeted temperature management. A total of 38% of patients survived to hospital discharge. There was no significant association between PaO<sub>2</sub> at any time interval and neurological outcome at hospital discharge. Hyperoxemia at 12 hours after cardiac arrest was associated with decreased odds of survival (OR 0.17 [0.03-0.89], p=0.032). There was no significant association between arterial oxygen tension measured within the first 48 hours after cardiac arrest and neurological outcome
UR  - https://dx.doi.org/10.1089/ther.2016.0015
ER  -