Post-resuscitation diastolic blood pressure is a prognostic factor for outcomes of cardiac arrest patients: a multicenter retrospective registry-based analysis

Abstract

Background Post-resuscitation hemodynamic level is associated with outcomes. This study was conducted to investigate if post-resuscitation diastolic blood pressure (DBP) is a favorable prognostic factor. Methods Using TaIwan Network of Targeted Temperature ManagEment for CARDiac Arrest (TIMECARD) registry, we recruited adult patients who received targeted temperature management in nine medical centers between January 2014 and September 2019. After excluding patients with extracorporeal circulation support, 448 patients were analyzed. The first measured, single-point blood pressure after resuscitation was used for analysis. Study endpoints were survival to discharge and discharge with favorable neurologic outcomes (CPC 1–2). Multivariate analysis, area under the receiver operating characteristic curve (AUC), and generalized additive model (GAM) were used for analysis. Results Among the 448 patients, 182 (40.7%) patients survived, and 89 (19.9%) patients had CPC 1–2. In the multivariate analysis, DBP > 70 mmHg was an independent factor for survival (adjusted odds ratio [aOR] 2.16, 95% confidence interval [CI, 1.41–3.31]) and > 80 mmHg was an independent factor for CPC 1–2 (aOR 2.04, 95% CI [1.14–3.66]). GAM confirmed that DBP > 80 mmHg was associated with a higher likelihood of CPC 1–2. In the exploratory analysis, patients with DBP > 80 mmHg had a significantly higher prevalence of cardiogenic cardiac arrest (p = 0.015) and initial shockable rhythm (p = 0.045). Conclusion We found that DBP after resuscitation can predict outcomes, as a higher DBP level correlated with cardiogenic cardiac arrest.

Comment on: Post‑resuscitation diastolic blood pressure is a prognostic factor for outcomes of cardiac arrest patients

“…Beyond these limitations, we agree with Chi et al [ 1 ] that DBP after cardiac arrest resuscitation reflects a lower severity of the post-resuscitation syndrome. Further studies are needed to clarify the causal link between the outcome and DBP after cardiac arrest.…”

“…We read with great interest the recent article published in the Journal by Chi et al [ 1 ] reporting that diastolic blood pressure (DBP) after cardiac arrest (CA) resuscitation can predict outcomes, as a higher DBP level correlated with better prognosis after cardiogenic CA.…”

Удк 616.12-008.313.315+577.17 Doi: 10.55359/2782-3296.2022.25.35.008 Тройная Комбинированная Терапия (Вазопрессин, Адреналин, Стероиды) И Новые Техники Сердчено-Легочной Реанимации (Обзор Литературы)

“…Эта гипотеза коррелирует с выводами о том, что пациенты с более высоким уровнем диастолического давления имели более высокий шанс возникновения ритма (ФЖ/ЖТ без пульса), требующего дефибрилляции, кардиогенной остановки сердца [54].…”