Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicenter observational registry-based study

被引：61

作者：

Shin, Jonghwan ^{[1
]}

Lim, Yong Su ^{[2
]}

Kim, Kyuseok ^{[3
]}

Lee, Hui Jai ^{[1
]}

Lee, Se Jong ^{[1
]}

Jung, Euigi ^{[1
]}

You, Kyoung Min ^{[1
]}

Yang, Hyuk Jun ^{[2
]}

Kim, Jin Joo ^{[2
]}

Kim, Joonghee ^{[3
]}

Jo, You Hwan ^{[3
]}

Lee, Jae Hyuk ^{[3
]}

Hwang, Seong Youn ^{[4
]}

机构：

[1] Seoul Natl Univ, Dept Emergency Med, Seoul Metropolitan Govt, Boramae Med Ctr, 20,Boramae Ro 5 Gil, Seoul 07061, South Korea

[2] Gachon Univ, Dept Emergency Med, Gil Med Ctr, 21,Namdong Daero 774 Beon Gil, Incheon 21565, South Korea

[3] Seoul Natl Univ, Dept Emergency Med, Bundang Hosp, 82,Gumi Ro 173 Beon Gil, Seongnam Si 13620, Gyeonggi Do, South Korea

[4] Sungkyunkwan Univ, Dept Emergency Med, Samsung Changwon Hosp, Sch Med, 158,Palyong Ro, Changwon Si 51353, Gyeongsangnam D, South Korea

来源：

CRITICAL CARE | 2017年 / 21卷

关键词：

Out-of-hospital cardiac arrest; Cardiopulmonary resuscitation; pH; ASSOCIATION GUIDELINES UPDATE; COUNCIL GUIDELINES; SEVERE ACIDEMIA; ARTERIAL; CARE; POINT; ELECTROLYTE; TERMINATION; PRESSURE; DURATION;

D O I：

10.1186/s13054-017-1893-9

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: When an out-of-hospital cardiac arrest (OHCA) patient receives cardiopulmonary resuscitation (CPR) in the emergency department (ED), blood laboratory test results can be obtained by using point-of-care testing during CPR. In the present study, the relationship between blood laboratory test results during CPR and outcomes of OHCA patients was investigated. Methods: This study was a multicenter retrospective analysis of prospective registered data that included 2716 OHCA patients. Data from the EDs of three university hospitals in different areas were collected from January 2009 to December 2014. Univariate and multivariable analyses were conducted to elucidate the factors associated with survival to discharge and neurological outcomes. A final analysis was conducted by including patients who had no prehospital return of spontaneous circulation and those who underwent rapid blood laboratory examination during CPR. Results: Overall, 2229 OHCA patients were included in the final analysis. Among them, the rate of survival to discharge and a good Cerebral Performance Categories Scale score were 14% and 4.4%, respectively. The pH level was independently related to survival to hospital discharge (adjusted OR 6.287, 95% CI 2.601-15.197; p < 0.001) and good neurological recovery (adjusted OR 15.395, 95% CI 3.439-68.911; p < 0.001). None of the neurologically intact patients had low pH levels (< 6.8) or excessive potassium levels (> 8.5 mEq/L) during CPR. Conclusions: Among the blood laboratory test results during CPR of OHCA patients, pH and potassium levels were observed as independent factors associated with survival to hospital discharge, and pH level was considered as an independent factor related to neurological recovery.

引用

页数：10

共 34 条

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