Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
Copenhagen Academy for Medical Education and Simulation, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
Acta Anaesthesiol Scand. 2019 Nov;63(10):1330-1336. doi: 10.1111/aas.13446. Epub 2019 Jul 23.
Hyperoxia after cardiac arrest may be associated with higher mortality, and trials have found that excess oxygen administration in patients with myocardial infarction is associated with increased infarct size. The effect of hyperoxia before cardiac arrest is sparsely investigated. Our aim was to assess the association between excessive oxygen administration before cardiac arrest and the extent of subsequent myocardial injury.
We performed a retrospective study including patients who had in-hospital cardiac arrest during 2014 in the Capital Region of Denmark. We excluded patients without peripheral oxygen saturation measurements within 48 hours before cardiac arrest. Patients were divided in three groups of pre-arrest oxygen exposure, based on average peripheral oxygen saturation and supplemental oxygen. Primary outcome was peak troponin concentration within 30 days. Secondary outcomes included 30-day mortality. Data were analyzed using multiple logistic regression and Wilcoxon rank sum test.
Of 163 patients with cardiac arrest, 28 had excessive oxygen administration (17%), 105 had normal oxygen administration (64%) and 30 had insufficient oxygen administration (18%) before cardiac arrest. Peak troponin was median 224 ng/L in the excessive oxygen administration group vs 365 ng/L in the normal oxygen administration group (P = .54); 20 of 28 (71%) in the excessive oxygen administration group died within 30 days compared to 54 of 105 (51%) in the normal oxygen administration group. (OR 1.87, 95% CI 0.56-6.19) CONCLUSIONS: Excessive oxygen administration within 48 hours before in-hospital cardiac arrest was not statistically associated with significantly higher peak troponin or mortality.
心脏骤停后过度吸氧可能与死亡率升高有关，且试验发现，心肌梗死患者过度供氧与梗死面积增大有关。心脏骤停前过度吸氧的影响研究较少。我们的目的是评估心脏骤停前过度供氧与随后心肌损伤程度之间的关联。
我们进行了一项回顾性研究，纳入了 2014 年丹麦首都大区院内发生心脏骤停的患者。我们排除了心脏骤停前 48 小时内无外周血氧饱和度测量值的患者。根据平均外周血氧饱和度和补充氧气，将患者分为三组进行心脏骤停前的氧暴露。主要结局为 30 天内的肌钙蛋白峰值浓度。次要结局包括 30 天死亡率。使用多项逻辑回归和 Wilcoxon 秩和检验分析数据。
在 163 名心脏骤停患者中，28 名患者有过度供氧（17%），105 名患者有正常供氧（64%），30 名患者有供氧不足（18%）。过度供氧组的肌钙蛋白峰值中位数为 224ng/L，正常供氧组为 365ng/L（P=0.54）；过度供氧组 28 名患者中有 20 名（71%）在 30 天内死亡，而正常供氧组 105 名患者中有 54 名（51%）死亡。（OR 1.87，95%CI 0.56-6.19）。
心脏骤停前 48 小时内过度供氧与肌钙蛋白峰值或死亡率的显著升高无统计学关联。
