Impact of hypotension after return of spontaneous circulation on survival in patients of out-of-hospital cardiac arrest

Chiu, Yu Koon; Lui, Chun Tat; Tsui, Kwok Leung

doi:10.1016/j.ajem.2017.07.019

Cited by 35 publications

(22 citation statements)

References 13 publications

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“…In our study, patients who suffered a cardiac arrest but had a perfusing rhythm at the time of ETI were included. Peri-cardiac arrest hypotension due to myocardial dysfunction is common and leads to poor outcomes [28,29]. In addition, data from Get-With-The-Guidelines registry has demonstrated that hypotension surrounding an acute respiratory compromise event is frequently associated with cardiac arrest [30].…”

Section: Clinical Utility Of Hyps and (S) Hypsmentioning

confidence: 99%

Risk factors for and prediction of post-intubation hypotension in critically ill adults: A multicenter prospective cohort study

et al. 2020

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Section: Clinical Utility Of Hyps and (S) Hypsmentioning

confidence: 99%

Risk factors for and prediction of post-intubation hypotension in critically ill adults: A multicenter prospective cohort study

et al. 2020

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“…American Heart Association (AHA) guideline statements recommend a MAP threshold of≥65mmHg (18) and current guidelines recognized that the evidence for targeted blood pressure is weak (10). Previous studies found the hypotension, particularly below the lower limit of autoregulation, among post-CA patients is associated with higher hospital mortality (13,(19)(20)(21)(22). In order to optimize post-resuscitation care, the management of blood pressure is very essential.…”

Section: Discussionmentioning

confidence: 99%

Association Between Mean Arterial Pressure and Survival in Patients Admitted to the Intensive Care Unit After Cardiac Arrest With Vasopressor Support: A Retrospective Study

Zhou

Zhang

et al. 2020

Preprint

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BackgroundMortality among patients admitted to the intensive care unit (ICU) after cardiac arrest (CA) is high. Hemodynamic management in the phase of post-resuscitation is recommended by international guidelines, but the optimal mean arterial pressure (MAP) range is still unclear. The main objective of this study is to investigate the association between time spent in different MAP and ICU mortality in PCA patients admitted to ICU with vasopressor support. MethodsIt was a retrospective, observational study in cardiac arrest patients admitted to the ICU with vasopressor support during the first 24 hours. The main exposure was time spent in MAP. The primary outcome was ICU mortality. Associations between time spent in MAP and ICU mortality were evaluated using ten MAP thresholds: 100, 95, 90, 85, 80, 75, 70, 65, 60, and 55 mmHg. Multivariable logistic regression analyses were used to test the association between time spent in different MAP categories and ICU mortality. Results The study included 1018 eligible subjects in ICUs from 156 hospitals, of which 453 (44%) patients died during hospitalization and 208 (37%) patients discharged home. A significant association was found between time spent in MAP and the ICU mortality when MAP thresholds of ≤55mmHg (OR 1.25, 95% CI 1.09-1. 45, p = 0.002) and ≤60 mmHg (OR 1.13, 95% CI 1.02-1.24, p = 0.014) were used. Thresholds of MAP ≥ 65 mmHg were not associated with mortality. The percentage of time spent in MAP of ≤90mmHg (OR 1.09, 95% CI 1.01-1.18), ≤ 95mmHg (OR 1.12, 95% CI 1.01-1.24,) and ≤100mmHg (OR 1.19, 95% CI 1.04-1.38) were associated with a higher odds ratio for discharged home outcome, suggesting that MAP of ≥90mmHg, ≥95mmHg and ≥100mmHg were associated with lower probability of discharged home. ConclusionsThese results imply that for post-cardiac arrest patients with vasopressor support, time spent in MAP of ≤60mmHg or less was associated with higher ICU mortality and MAP of ≥90 mmHg or more was associated with a lower probability for discharged home.

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“…Hypotension after ROSC (defined as systolic blood pressure < 90 mmHg or MAP < 65 mmHg) is associated with death and poor neurological outcomes in a number of observational studies. [28][29][30][31][32][33][34] However, the evidence is insufficient to determine a specific hemodynamic goal for post-cardiac arrest patients. It is suggested that hypotension should be corrected quickly, and a hemodynamic goal should be determined for individual patients, while maintaining a systolic blood pressure > 100 mmHg.…”

Section: Circulation Hemodynamic Stabilizationmentioning

confidence: 99%

2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 5. Post-cardiac arrest care

et al. 2021

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The 2020 Korean Post-cardiac Arrest Care Guidelines are medical recommendations derived based on scientific evidence for post-cardiac arrest care. These guidelines are based on the 2020 scientific consensus and treatment recommendations of the International Liaison Committee on Resuscitation and we additionally considered the research papers in the post-cardiac arrest care field which were published after the International Liaison Committee on Resuscitation review. 1,2 In these guidelines, topics which are clinically important and needed further consideration were reviewed in the form of adaptation or hybridization. Meta-analyses or scoping reviews for addi-S42 www.ceemjournal.org 2020 CPR guidelines: post-cardiac arrest care Use of prophylactic antibioticsThe benefit of the routine use of prophylactic antibiotics in pa-S43

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Impact of hypotension after return of spontaneous circulation on survival in patients of out-of-hospital cardiac arrest

Cited by 35 publications

References 13 publications

Risk factors for and prediction of post-intubation hypotension in critically ill adults: A multicenter prospective cohort study

Risk factors for and prediction of post-intubation hypotension in critically ill adults: A multicenter prospective cohort study

Association Between Mean Arterial Pressure and Survival in Patients Admitted to the Intensive Care Unit After Cardiac Arrest With Vasopressor Support: A Retrospective Study

2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 5. Post-cardiac arrest care

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