Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients

Çalbay, Ayça; Çakır, Zeynep; Bayramoğlu, Atıf

doi:10.3906/sag-1812-156

Cited by 8 publications

(7 citation statements)

References 12 publications

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“…Median pCO2 was 54.55 mmHg in patients who had ROSC and 68.5 mmHg in patients who died and statistically significant was found (p=0.0012). Median pO2 value was 51.5 mmHg in patients who had ROSC and 26.85 mmHg in patients who did not have ROSC and the difference was found to be statistically significant (p=0.0006) (12). Similarly, in our arrest population with 309 individuals we included in the study, when blood gas parameters were compared, median pH was 7.20 (7.3-7.35) in patients who had ROSC and 7.02 (6.86-7.19) in patients who did not have ROSC and the difference between was found to be significant (p<0.0001).…”

Section: Resultsmentioning

confidence: 86%

Early predictors of return of spontaneous circulation in patients undergoing cardiopulmonary resuscitation

NALBANT¹,

Altuntaş²,

Çelik³

et al. 2022

J Exp Clin Med

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Decisions about when to start, how long to continue and how to end cardiopulmonary resuscitation (CPR) are important in the management of these critically ill patients. The aim of our study is to determine the factors that can help in the early prediction of patients in whom spontaneous circulation can be restored during CPR. Patients who had arrest due to nontraumatic causes were included in the study. The patients whose spontaneous circulation (ROSC) was restored in the emergency service and who were hospitalized in intensive care were included in ROSC (+) group, while the patients who did not have ROSC and who became exitus were included in ROSC (-) group. Patients' demographic characteristics, chronic diseases, places of arrest, admission laboratory values and possible causes of death were compared between ROSC groups. This study was conducted with the retrospective examination of 309, 118 (38.2%) female and 191 (61.8%) male, cardiopulmonary arrest cases. ROSC was achieved in 94 (30.4%) of the patients who underwent CPR. It was found that a 0,1 unit increase in pH value increased the probability of ROSC by 38% [OR: 1,38 (95% CI: 1.22-1.55), p<0.0001], while multivariate logistic regression analysis showed that it could be an independent predictor of ROSC and increased the probability of survival by 0,43 times [Corrected OR: 1.43 (95% CI: 1.13-1.83), p=0.0033]. It was also found with multivariate logistic regression analysis that respiratory causes could be an independent predictor of ROSC and increased the probability of survival by 2.76 times [Corrected OR: 3,76 (95% CI=1,499.53), p=0.0052]. In patients who undergo CPR, pH value in blood gas analysis and the presence of respiratory system diseases as the cause of arrest are important parameters in determining the probability of ROSC.

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Section: Resultsmentioning

confidence: 86%

Early predictors of return of spontaneous circulation in patients undergoing cardiopulmonary resuscitation

NALBANT¹,

Altuntaş²,

Çelik³

et al. 2022

J Exp Clin Med

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“…The search strategy identified a total of 11,834 records, of which 6914 were non‐duplicates. After applying all inclusion and exclusion criteria, 118 studies were included in the scoping review, as shown in Figure 1 11–128 …”

Section: Resultsmentioning

confidence: 99%

“…After applying all inclusion and exclusion criteria, 118 studies were included in the scoping review, as shown in Figure 1 . 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ,…”

Section: Resultsmentioning

confidence: 99%

Intra‐arrest blood‐based biomarkers for out‐of‐hospital cardiac arrest: A scoping review

Benoit,

Hogan,

Connelly

et al. 2024

JACEP Open

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ObjectiveBlood‐based biomarkers play a central role in the diagnosis and treatment of critically ill patients, yet none are routinely measured during the intra‐arrest phase of out‐of‐hospital cardiac arrest (OHCA). Our objective was to describe methodological aspects, sources of evidence, and gaps in research surrounding intra‐arrest blood‐based biomarkers for OHCA.MethodsWe used scoping review methodology to summarize existing literature. The protocol was designed a priori following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) Extension for Scoping Reviews. Inclusion criteria were peer‐reviewed scientific studies on OHCA patients with at least one blood draw intra‐arrest. We excluded in‐hospital cardiac arrest and animal studies. There were no language, date, or study design exclusions. We conducted an electronic literature search using PubMed and Embase and hand‐searched secondary literature. Data charting/synthesis were performed in duplicate using standardized data extraction templates.ResultsThe search strategy identified 11,834 records, with 118 studies evaluating 105 blood‐based biomarkers included. Only eight studies (7%) had complete reporting. The median number of studies per biomarker was 2 (interquartile range 1–4). Most studies were conducted in Asia (63 studies, 53%). Only 22 studies (19%) had blood samples collected in the prehospital setting, and only six studies (5%) had samples collected by paramedics. Pediatric patients were included in only three studies (3%). Out of eight predefined biomarker categories of use, only two were routinely assessed: prognostic (97/105, 92%) and diagnostic (61/105, 58%).ConclusionsDespite a large body of literature on intra‐arrest blood‐based biomarkers for OHCA, gaps in methodology and knowledge are widespread.

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“…Çalbay et al [32] analyzed initial blood gas from OHCA patients at admission to emergency room (ER) and repeated measurements within 5 after achieving ROSC and found no correlation between the levels of lactate and ROSC. They reported that PCO 2 was significant in ROSC estimation and could be used with EtCO 2 to strengthen the estimation of ROSC [32].…”

Section: Discussionmentioning

confidence: 99%

Dynamics of Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac Arrest

Vujanović,

Borovnik Lesjak,

Mekiš

et al. 2023

Medicina

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Background and Objectives: An effective strategy for cardiopulmonary resuscitation should be based on tissue perfusion. Our primary aim was to determine the association between capillary lactate values and initial rhythm as well as the probability of the return of spontaneous circulation in out-of-hospital cardiac arrest patients. Materials and Methods: This prospective observational cohort study included all patients with non-traumatic out-of-hospital cardiac arrest, older than 18 years, resuscitated by a prehospital emergency medical team between April 2020 and June 2021. Capillary lactate samples were collected at the time of arrival and every 10 min after the first measurement until the time of the return of spontaneous circulation (ROSC) or, if ROSC was not achieved, at the time of declaring death on the scene. Results: In total, 83 patients were enrolled in the study. ROSC was achieved in 28 patients (33.7%), 21 were admitted to hospital (26.3%), and 6 (7.23%) of them were discharged from hospital. At discharge, all patients had Cerebral Performance Category Scale 1 or 2. Initial capillary lactate values were significantly higher in patients with a non-shockable rhythm compared to the group with a shockable rhythm (9.19 ± 4.6 versus 6.43 ± 3.81; p = 0.037). A significant difference also persisted in a second value taken 10 min after the initial value (10.03 ± 5,19 versus 5.18 ± 3.47; p = 0.019). Capillary lactate values were higher in the ROSC group and non-ROSC group at the time of restored circulation (11.10 ± 6.59 and 6.77 ± 4.23, respectively; p = 0.047). Conclusions: Capillary lactate values are significantly higher in patients with a non-shockable first rhythm in out-of-hospital cardiac arrest (OHCA). There is also a significantly different rise in capillary lactate levels in patients with ROSC.

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Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients

Cited by 8 publications

References 12 publications

Early predictors of return of spontaneous circulation in patients undergoing cardiopulmonary resuscitation

Early predictors of return of spontaneous circulation in patients undergoing cardiopulmonary resuscitation

Intra‐arrest blood‐based biomarkers for out‐of‐hospital cardiac arrest: A scoping review

Dynamics of Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac Arrest

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