Zama Cavicchi Federica, Iesu Enrica, Franchi Federico, Nobile Leda, Annoni Filippo, Vincent Jean-Louis, Scolletta Sabino, Creteur Jacques, Taccone Fabio Silvio
Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Department of Emergency Medicine, Surgery and Neurosciences, Intensive Care Unit, Università di Siena, Siena, Italy.
Resuscitation. 2020 Aug;153:202-208. doi: 10.1016/j.resuscitation.2020.06.020. Epub 2020 Jun 24.
Hemoglobin (Hb) is a main determinant of tissue oxygen delivery and anemia could be particularly harmful in post-anoxic brain injury. The aim of this study was to evaluate the association of Hb and venous Hb oxygen saturation (SvO/ScvO) with long-term neurological outcome in patients admitted after cardiac arrest (CA).
Analysis of adult CA patients admitted to the Department of Intensive Care of the Erasme University Hospital (Brussels, Belgium) over 9 years. We retrieved all data concerning CA characteristics as well as Hb during the first 48 h since injury as well as the need for red blood cells transfusions (RBCT). Minimum Hb and Hb oxygen saturation values were recorded. Neurological outcome was evaluated 3 months after CA. Unfavorable neurological outcome (UO) was defined as a Cerebral Performance Categories (CPC) score of 3-5.
We treated 414 patients patients with CA, including 231 (56%) out-of-hospital cardiac arrest (OHCA) and 158 (38%) with an initial shockable rhythm. Median Hb concentration on admission was 12.0 [9.9-13.7] g/dL and the lowest Hb concentration was 10.0 [8.1-11.0] g/dL; 127 patients (31%) received at least one RBCT. Hb oxygen saturation on admission was 67 [59-74]%, while the lowest value was 60 [53-68]%. Low Hb and Hb oxygen saturation values were independently associated with UO; the optimal cut-off to predict UO was <9.9 g/dL and <60%, respectively.
Low hemoglobin values and low values of oxygen venous saturation are significantly associated with unfavorable neurological outcome in adult patients resuscitated from cardiac arrest.
血红蛋白（Hb）是组织氧输送的主要决定因素，贫血在缺氧性脑损伤后可能尤其有害。本研究的目的是评估心脏骤停（CA）后入院患者的Hb和静脉血Hb氧饱和度（SvO/ScvO）与长期神经功能结局之间的关联。
对9年间在伊拉斯谟大学医院（比利时布鲁塞尔）重症监护科收治的成年CA患者进行分析。我们收集了所有关于CA特征以及受伤后最初48小时内的Hb数据以及红细胞输注（RBCT）需求。记录最低Hb和Hb氧饱和度值。CA后3个月评估神经功能结局。不良神经功能结局（UO）定义为脑功能分类（CPC）评分为3 - 5分。
我们治疗了414例CA患者，其中包括231例（56%）院外心脏骤停（OHCA）患者和158例（38%）初始可电击心律患者。入院时Hb浓度中位数为12.0 [9.9 - 13.7] g/dL，最低Hb浓度为10.0 [8.1 - 11.0] g/dL；127例患者（31%）接受了至少一次RBCT。入院时Hb氧饱和度为67 [59 - 74]%，而最低值为60 [53 - 68]%。低Hb和低Hb氧饱和度值与UO独立相关；预测UO的最佳临界值分别为<9.9 g/dL和<60%。
在从心脏骤停复苏的成年患者中，低血红蛋白值和低静脉血氧饱和度值与不良神经功能结局显著相关。
