The effect of hyperoxia on survival following adult cardiac arrest: A systematic review and meta-analysis of observational studies

Wang, Chih‐Hung; Chang, Wei‐Tien; Huang, Chien‐Hua; Tsai, Min‐Shan; Yu, Ping; Wang, An Yi; Chen, N. C.; Chen, Wen‐Jone

doi:10.1016/j.resuscitation.2014.05.021

Cited by 157 publications

(110 citation statements)

References 34 publications

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“…Other studies confirm these findings. 27,28 A study by Meyhoff et al 29 even reported a long-term mortality in patients receiving abdominal surgery. Twenty-three percent of the patients died in the group ventilated with a FiO 2 of 0.8 versus 18.3% in the group with a FiO 2 of only 0.3 in this randomized trial follow-up.…”

Section: Downloaded From Hyperoxia Worsens Myocardial Ischemiamentioning

confidence: 99%

Hyperoxia Exacerbates Myocardial Ischemia in the Presence of Acute Coronary Artery Stenosis in Swine

Guensch

Fischer

Shie

et al. 2015

Circ: Cardiovascular Interventions

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Background-Current guidelines limit the use of high oxygen tension after return of spontaneous circulation after cardiac arrest, focusing on neurological outcome and mortality. Little is known about the impact of hyperoxia on the ischemic heart. Oxygen is frequently administered and is generally expected to be beneficial. This study seeks to assess the effects of hyperoxia on myocardia oxygenation in the presence of severe coronary artery stenosis in swine. Methods and Results-In 22 healthy pigs, we surgically attached a magnetic resonance compatible flow probe to the left anterior descending coronary artery (LAD). In 11 pigs, a hydraulic occluder was inflated distal to the flow probe. After increasing PaO 2 to >300 mm Hg, LAD flow decreased in all animals. In 8 stenosed animals with a mean fractional flow reserve of 0.64±0.02, hyperoxia resulted in a significant decrease of myocardial signal intensity in oxygenationsensitive cardiovascular magnetic resonance images of the midapical segments of the LAD territory. This was not seen in remote myocardium or in the other 8 healthy animals. The decreased signal intensity was accompanied by a decrease in circumferential strain in the same segments. Furthermore, ejection fraction, cardiac output, and oxygen extraction ratio declined in these animals. Changing PaCO 2 levels did not have a significant effect on any of the parameters; however, hypercapnia seemed to nonsignificantly attenuate the hyperoxia-induced changes. Conclusions-Ventilation-induced hyperoxia may decrease myocardial oxygenation and lead to ischemia in myocardium subject to severe coronary artery stenosis. (Circ Cardiovasc Interv. 2015;8:e002928.

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Section: Downloaded From Hyperoxia Worsens Myocardial Ischemiamentioning

confidence: 99%

Hyperoxia Exacerbates Myocardial Ischemia in the Presence of Acute Coronary Artery Stenosis in Swine

Guensch

Fischer

Shie

et al. 2015

Circ: Cardiovascular Interventions

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“…Furthermore, future randomized controlled studies focusing on the effect of hyperoxia avoidance [33], arterial pressure maintenance [34], and early coronary intervention [35] on patient outcomes might be necessary.…”

Section: A Rebuttal For Therapeutic Hypothermiamentioning

confidence: 99%

Controversies in the temperature management of critically ill patients

Nakajima

2016

J Anesth

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Although body temperature is a classic primary vital sign, its value has received little attention compared with the others (blood pressure, heart rate, and respiratory rate). This may result from the fact that unlike the other primary vital signs, aging and diseases rarely affect the thermoregulatory system. Despite this, when humans are exposed to various anesthetics and analgesics and acute etiologies of non-infectious and infectious diseases in perioperative and intensive care settings, abnormalities may occur that shift body temperature up and down. A recent upsurge in clinical evidence in the perioperative and critical care field resulted in many clinical trials in temperature management. The results of these clinical trials suggest that aggressive body temperature modifications in comatose survivors after resuscitation from shockable rhythm, and permissive fever in critically ill patients, are carried out in critical care settings to improve patient outcomes; however, its efficacy remains to be elucidated. A recent, large multicenter randomized controlled trial demonstrated contradictory results, which may disrupt the trends in clinical practice. Thus, updated information concerning thermoregulatory interventions is essential for anesthesiologists and intensivists. Here, recent controversies in therapeutic hypothermia and fever management are summarized, and their relevance to the physiology of human thermoregulation is discussed.

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“…Hyperoxia drives the formation of reactive oxygen species, overwhelming antioxidants at sites of tissue injury; directly injures respiratory epithelium and alveoli inducing inflammation; drives hypercarbia; and leads to absorption atelectasis in the lung. Hyperoxia (PaO 2 > 300 mmHg) immediately following resuscitation is independently associated with poor outcomes in TBI and cardiac arrest [53,54], though not all published data are in accordance [55][56][57].…”

Section: Oxygenation and Outcomesmentioning

confidence: 99%

Emergency Neurological Life Support: Airway, Ventilation, and Sedation

Seder

Jagoda

2015

Neurocrit Care

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Airway management and ventilation are central to the resuscitation of the neurologically ill. These patients often have evolving processes that threaten the airway and adequate ventilation. Furthermore, intubation, ventilation, and sedative choices directly affect brain perfusion. Therefore, airway, ventilation, and sedation was chosen as an emergency neurological life support protocol. Topics include airway management, when and how to intubate with special attention to hemodynamics and preservation of cerebral blood flow, mechanical ventilation settings, and the use of sedative agents based on the patient's neurological status.

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The effect of hyperoxia on survival following adult cardiac arrest: A systematic review and meta-analysis of observational studies

Cited by 157 publications

References 34 publications

Hyperoxia Exacerbates Myocardial Ischemia in the Presence of Acute Coronary Artery Stenosis in Swine

Hyperoxia Exacerbates Myocardial Ischemia in the Presence of Acute Coronary Artery Stenosis in Swine

Controversies in the temperature management of critically ill patients

Emergency Neurological Life Support: Airway, Ventilation, and Sedation

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