心脏骤停后早期高氧血症可能不会增加死亡率：一项初步研究。
Early hyperoxemia may not increase mortality after cardiac arrest: a pilot study.
作者信息
Oh Young Taeck, Kim Yong Hwan, Sohn You Dong, Park Seung Min, Shin Dong Hyuk, Hwang Seong Youn, Cho Suck Ju, Park Sang O, Hong Chong Kun, Ahn Hee Cheol, Lee Young Hwan
机构信息
Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University School of Medicine, Anyang, Korea.
Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
出版信息
Clin Exp Emerg Med. 2014 Sep 30;1(1):28-34. doi: 10.15441/ceem.14.017. eCollection 2014 Sep.
OBJECTIVE
International Liaison Committee on Resuscitation guidelines advocate an arterial saturation of 94% to 96% after return of spontaneous circulation (ROSC). However, a few clinical trials have investigated the impact of postresuscitative O therapy after cardiac arrest. We studied whether early hyperoxemia is associated with a poor post-ROSC outcome after in-hospital cardiac arrest.
METHODS
We retrospectively reviewed patients who experienced an in-hospital cardiac arrest from January 2005 to January 2011. Based on the results of the first arterial blood gas analysis (ABGA) within 10 minutes and a second ABGA from 60 to 120 minutes after ROSC, patients were classified into three groups: hyperoxemia (PaO ≥ 300 mmHg), normoxemia (300 mmHg > PaO ≥ 60 mmHg), and hypoxemia (PaO < 60 mmHg or ratio of PaO to fraction of inspired oxygen < 300). We examined whether early hyperoxemia was associated with survival and neurological outcome.
RESULTS
There were 792 patients who met the inclusion criteria: 638 (80.6%) in the hypoxemia group, 62 (7.8%) in the normoxemia group, and 92 (11.6%) in the hyperoxemia group. Multiple logistic regression analysis showed that hyperoxemia was not associated with survival (odds ratio [OR], 1.07; 95% confidence interval [CI], 0.30 to 3.84) or neurological outcome (OR, 1.03; 95% CI, 0.31 to 3.40).
CONCLUSION
Postresuscitation hyperoxemia was not associated with survival or neurological outcome in patients with ROSC after in-hospital cardiac arrest.
目的
国际复苏联合委员会指南提倡自主循环恢复（ROSC）后动脉血氧饱和度维持在94%至96%。然而，仅有少数临床试验研究了心脏骤停后复苏期氧疗的影响。我们研究了院内心脏骤停后早期高氧血症是否与ROSC后不良结局相关。
方法
我们回顾性分析了2005年1月至2011年1月期间发生院内心脏骤停的患者。根据复苏后10分钟内首次动脉血气分析（ABGA）结果以及ROSC后60至120分钟的第二次ABGA结果，将患者分为三组：高氧血症组（动脉血氧分压[PaO₂]≥300 mmHg）、正常氧血症组（300 mmHg＞PaO₂≥60 mmHg）和低氧血症组（PaO₂＜60 mmHg或PaO₂与吸入氧分数之比＜300）。我们研究了早期高氧血症是否与生存及神经功能结局相关。
结果
共有792例患者符合纳入标准：低氧血症组638例（80.6%），正常氧血症组62例（7.8%），高氧血症组92例（11.6%）。多因素逻辑回归分析显示，高氧血症与生存（优势比[OR]，1.07；95%置信区间[CI]，0.30至3.84）或神经功能结局（OR，1.03；95% CI，0.31至3.40）无关。
结论
院内心脏骤停患者ROSC后，复苏期高氧血症与生存或神经功能结局无关。
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