Abstract：
Hyperoxia has been associated with adverse outcomes in post cardiac arrest (CA) patients. Study-objective was to examine the association between hyperoxia and 30-day mortality in a mixed cohort of two different modes of Cardiopulmonary Resuscitation (CPR): Extracorporeal (ECPR) vs. Conventional (CCPR).
In this retrospective cohort study of CA patients admitted to a tertiary level CA centre in Australia (over a 6.5-year time period) mean arterial oxygen levels (PaO2) and episodes of extreme hyperoxia (maximum of mean PaO2 ≥ 300 mmHg) were analysed over the first 8 days post CA.
One hundred and sixty-nine post CA patients were assessed (ECPR n = 79 / CCPR n = 90). Mean PaO2-levels were higher in the ECPR vs CCPR group (211 mmHg ± 58.4 vs 119 mmHg ± 18.1; p < 0.0001) as was the proportion with at least one episode of extreme hyperoxia (74.7% vs 16.7%; p < 0.001). After adjusting for confounders and the mode of CPR any episode of extreme hyperoxia was independently associated with a 2.52-fold increased risk of 30-day mortality (OR: 2.52, 95% CI: 1.06-5.98; p = 0.036).
We found extreme hyperoxia was more common in ECPR patients in the first 8 days post CA and independently associated with higher 30-day mortality, irrespective of the CPR-mode.
In this retrospective cohort study of CA patients admitted to a tertiary level CA centre in Australia (over a 6.5-year time period) mean arterial oxygen levels (PaO2) and episodes of extreme hyperoxia (maximum of mean PaO2 ≥ 300 mmHg) were analysed over the first 8 days post CA.
One hundred and sixty-nine post CA patients were assessed (ECPR n = 79 / CCPR n = 90). Mean PaO2-levels were higher in the ECPR vs CCPR group (211 mmHg ± 58.4 vs 119 mmHg ± 18.1; p < 0.0001) as was the proportion with at least one episode of extreme hyperoxia (74.7% vs 16.7%; p < 0.001). After adjusting for confounders and the mode of CPR any episode of extreme hyperoxia was independently associated with a 2.52-fold increased risk of 30-day mortality (OR: 2.52, 95% CI: 1.06-5.98; p = 0.036).
We found extreme hyperoxia was more common in ECPR patients in the first 8 days post CA and independently associated with higher 30-day mortality, irrespective of the CPR-mode.
摘要：
高氧与心脏骤停（CA）后患者的不良后果有关。研究目的是在两种不同模式的心肺复苏（CPR）的混合队列中检查高氧与30天死亡率之间的关系：体外（ECPR）与常规（CCPR）。
在这项回顾性队列研究中，对澳大利亚三级CA中心收治的CA患者（在6.5年的时间内）的平均动脉血氧水平（PaO2）和极端高氧发作（最大平均PaO2≥300mmHg）进行了分析。
评估了一百六十九名CA后患者（ECPRn=79/CCPRn=90）。ECPR与CCPR组的平均PaO2水平较高（211mmHg±58.4vs119mmHg±18.1；p<0.0001），至少有一次极端高氧发作的比例（74.7％vs16.7％；p<0.001）。在校正混杂因素和CPR模式后，任何极端高氧事件都与30天死亡率增加2.52倍的风险独立相关（OR：2.52，95％CI：1.06-5.98；p=0.036）。
我们发现，在CA后的前8天，ECPR患者中极端高氧更为常见，并且与更高的30天死亡率独立相关。无论CPR模式如何。
在这项回顾性队列研究中，对澳大利亚三级CA中心收治的CA患者（在6.5年的时间内）的平均动脉血氧水平（PaO2）和极端高氧发作（最大平均PaO2≥300mmHg）进行了分析。
评估了一百六十九名CA后患者（ECPRn=79/CCPRn=90）。ECPR与CCPR组的平均PaO2水平较高（211mmHg±58.4vs119mmHg±18.1；p<0.0001），至少有一次极端高氧发作的比例（74.7％vs16.7％；p<0.001）。在校正混杂因素和CPR模式后，任何极端高氧事件都与30天死亡率增加2.52倍的风险独立相关（OR：2.52，95％CI：1.06-5.98；p=0.036）。
我们发现，在CA后的前8天，ECPR患者中极端高氧更为常见，并且与更高的30天死亡率独立相关。无论CPR模式如何。
