Arterial oxygen and carbon dioxide tension and acute brain injury in extracorporeal cardiopulmonary resuscitation patients: Analysis of the extracorporeal life support organization registry

被引：28
|
作者：
Shou, Benjamin L. [1 ]
Ong, Chin Siang [2 ]
Premraj, Lavienraj [3 ,4 ]
Brown, Patricia [1 ]
Tonna, Joseph E. [5 ,6 ]
Dalton, Heidi J. [7 ]
Kim, Bo Soo [8 ]
Keller, Steven P. [8 ,9 ]
Whitman, Glenn J. R. [1 ]
Cho, Sung -Min [1 ,10 ,11 ,12 ,13 ,14 ]
机构：
[1] Johns Hopkins Univ, Dept Surg, Div Cardiac Surg, Sch Med, Baltimore, MD USA
[2] Yale Sch Med, Dept Surg, Div Surg Outcomes, New Haven, CT USA
[3] Griffith Univ, Sch Med, Gold Coast, Qld, Australia
[4] Prince Charles Hosp, Crit Care Res Grp, Brisbane, Qld, Australia
[5] Univ Utah Hlth, Dept Surg, Div Cardiothorac Surg, Salt Lake City, UT USA
[6] Univ Utah Hlth, Dept Emergency Med, Salt Lake City, UT USA
[7] INOVA Fairfax Med Ctr, Adult & Pediat Extracorporeal Life Support, Falls Church, VA USA
[8] Johns Hopkins Univ, Div Pulm & Crit Care Med, Sch Med, Baltimore, MD USA
[9] Johns Hopkins Univ, Dept Biomed Engn, Baltimore, MD USA
[10] Johns Hopkins Univ, Dept Neurol Neurosurg Anesthesia & Crit Care Med, Div Neurosci Crit Care, Sch Med, Baltimore, MD USA
[11] Johns Hopkins Univ, Dept Neurol, Div Neurosci Crit Care, Div Cardiac Surg, 600 N Wolfe St,Phipps 455, Baltimore, MD 21287 USA
[12] Johns Hopkins Univ, Dept Neurosurg, Div Neurosci Crit Care, Div Cardiac Surg, 600 N Wolfe St,Phipps 455, Baltimore, MD 21287 USA
[13] Johns Hopkins Univ, Dept Surg, Div Neurosci Crit Care, Div Cardiac Surg, 600 N Wolfe St,Phipps 455, Baltimore, MD 21287 USA
[14] Johns Hopkins Univ, Dept Anesthesia & Crit Care Med, Div Neurosci Crit Care, Div Cardiac Surg, 600 N Wolfe St,Phipps 455, Baltimore, MD 21287 USA
来源：
JOURNAL OF HEART AND LUNG TRANSPLANTATION | 2023年 / 42卷 / 04期
关键词：
neurological injury; extracorporeal membrane oxygenation; ECPR; MEMBRANE-OXYGENATION; HYPEROXIC REPERFUSION; HEMORRHAGIC STROKES; CARDIAC-ARREST; RISK-FACTORS; OUTCOMES; FLOW;
D O I：
10.1016/j.healun.2022.10.019
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
BACKGROUND: Acute brain injury (ABI) remains common after extracorporeal cardiopulmonary resuscitation (ECPR). Using a large international multicenter cohort, we investigated the impact of peri-cannulation arterial oxygen (PaO2) and carbon dioxide (PaCO2) on ABI occurrence. METHODS: We retrospectively analyzed adult (>= 18 years old) ECPR patients in the Extracorporeal Life Support Organization registry from 1/2009 through 12/2020. Composite ABI included ische-mic stroke, intracranial hemorrhage (ICH), seizures, and brain death. The registry collects 2 blood gas data pre-(6 hours) and post-(24 hours) cannulation. Blood gas parameters were classi-fied as: hypoxia (<60mm Hg), normoxia (60-119mm Hg), and mild (120-199mm Hg), moderate (200-299mm Hg), and severe hyperoxia (>= 300mm Hg); hypocarbia (<35mm Hg), normocarbia (35-44mm Hg), mild (45-54mm Hg) and severe hypercarbia (>= 55mm Hg). Missing values were handled using multiple imputation. Multivariable logistic regression analysis was used to assess the relationship of PaO2 and PaCO2 with ABI.
引用
收藏
页码：503 / 511
页数：9
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