Survival in extremely acidotic cardiac arrest patients depends on etiology of acidosis

Ilicki, Jonathan; Djärv, Therese

doi:10.1016/j.resuscitation.2016.12.030

Cited by 9 publications

(8 citation statements)

References 5 publications

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“…These patients were relatively young, with shockable rhythms and OHCA witnessed by bystanders. A previous case series also reported that some patients with severe acidemia could achieve good recovery from OHCA in some situations [32]. Furthermore, in our study, the discrimination ability of pH (AUC_ROC) was 0.675 [95% CI 0.573-0.763], which is not adequately high for predicting the neurological outcome definitely.…”

Section: Clinical Implicationcontrasting

confidence: 69%

Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan

et al. 2020

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Background: We aimed to identify the association of pH value in blood gas assessment with neurological outcome among out-of-hospital cardiac arrest (OHCA) patients treated by extracorporeal cardiopulmonary resuscitation (ECPR). Methods: We retrospectively analyzed the database of a multicenter prospective observational study on OHCA patients in Osaka prefecture, Japan (CRITICAL study), from July 1, 2012 to December 31, 2016. We included adult OHCA patients treated by ECPR. Patients with OHCA from external causes such as trauma were excluded. We conducted logistic regression analysis to identify the odds ratio (OR) and 95% confidence interval (CI) of the pH value for 1 month favorable neurological outcome adjusted for potential confounders including sex, age, witnessed by bystander, CPR by bystander, pre-hospital initial cardiac rhythm, and cardiac rhythm on hospital arrival.

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Section: Clinical Implicationcontrasting

confidence: 69%

Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan

et al. 2020

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“…100% specific). In our population, the lowest post-ROSC pH in a patient experiencing a favorable neurologic outcome was 6.94, however reports exist of full neurologic recovery at pH 6.33-6.85, primarily occurring in young patients with known cardiovascular triggers of arrest (32).…”

Section: Discussionmentioning

confidence: 66%

Initial arterial pH as a predictor of neurologic outcome after out-of-hospital cardiac arrest: A propensity-adjusted analysis

et al. 2019

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research mentor, and to Dr. Venu Menon, my cardiology fellowship program director and original sponsor of this specific research pursuit and my scholarship award for the CRSP program. Both have been wonderful professional and personal role models for me and have supported me steadfastly through difficult personal times. I am fortunate to call them both great friends. Thanks to Dr. Mehdi Razavi, who provided the funding for the completion of this degree. This project began nearly 8 years ago during my intern year at the University of Virginia. It first culminated in creation of the C-GRApH scoring system, published in JAHA in 2017, and now has led to this extended post-hoc pH analysis in my last year of postgraduate training. In Charlottesville, I owe thanks to Drs.

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“…Indeed, acidosis is a cardiotoxic state and can impair oxygen delivery to tissues, making resuscitation attempts even more difficult. Cases of ROSC with full recovery in patients with intra-arrest acidosis below this have been documented in hemorrhagic shock, raised anion-gap acidosis, and drowning, but not following PE-induced cardiac arrest [ 17 ]. This raises the ethical debate as to when to cease resuscitation efforts in cases of potentially reversible cardiac arrest causes and what defines the "point of futility".…”

Section: Discussionmentioning

confidence: 99%

Successful Intraosseous Thrombolysis in the Management of a Massive Pulmonary Embolism With Cardiac Arrest

Nweze

Ribeiro

Kelly

et al. 2020

Cureus

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Survival in extremely acidotic cardiac arrest patients depends on etiology of acidosis

Cited by 9 publications

References 5 publications

Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan

Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan

Initial arterial pH as a predictor of neurologic outcome after out-of-hospital cardiac arrest: A propensity-adjusted analysis

Successful Intraosseous Thrombolysis in the Management of a Massive Pulmonary Embolism With Cardiac Arrest

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