Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea.
Sci Rep. 2021 Nov 30;11(1):23165. doi: 10.1038/s41598-021-02764-4.
We aimed to investigate the prognostic value of dynamic changes in arterial blood gas analysis (ABGA) measured after the start of cardiopulmonary resuscitation (CPR) for return of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest (OHCA). This prospective observational study was conducted at the emergency department of a university hospital from February 2018 to February 2020. All blood samples for gas analysis were collected from a radial or femoral arterial line, which was inserted during CPR. Changes in ABGA parameters were expressed as delta (Δ), defined as the values of the second ABGA minus the values of the initial ABGA. The primary outcome was sustained ROSC. Out of the 80 patients included in the analysis, 13 achieved sustained ROSC after in-hospital resuscitation. Multivariable logistic analysis revealed that ΔpaO (odds ratio [OR] = 1.023; 95% confidence interval [CI] = 1.004-1.043, p = 0.020) along with prehospital shockable rhythm (OR = 84.680; 95% CI = 2.561-2799.939, p = 0.013) and total resuscitation duration (OR = 0.881; 95% CI = 0.805-0.964, p = 0.006) were significant predictors for sustained ROSC. Our study suggests a possible association between ΔpaO in ABGA during CPR and an increased rate of sustained ROSC in the late phase of OHCA.
我们旨在探讨心肺复苏（CPR）开始后动脉血气分析（ABGA）的动态变化对院外心脏骤停（OHCA）患者自主循环恢复（ROSC）的预后价值。这项前瞻性观察性研究于 2018 年 2 月至 2020 年 2 月在一家大学医院的急诊科进行。所有血气分析的血样均取自桡动脉或股动脉，在 CPR 期间插入。ABGA 参数的变化用增量（Δ）表示，定义为第二次 ABGA 值减去初始 ABGA 值。主要结局是持续 ROSC。在纳入分析的 80 例患者中，13 例在院内复苏后实现持续 ROSC。多变量逻辑分析显示，ΔpaO（比值比[OR] = 1.023；95%置信区间[CI] = 1.004-1.043，p = 0.020）以及院前可除颤节律（OR = 84.680；95%CI = 2.561-2799.939，p = 0.013）和总复苏持续时间（OR = 0.881；95%CI = 0.805-0.964，p = 0.006）是持续 ROSC 的显著预测因素。我们的研究表明，CPR 期间 ABGA 中的ΔpaO 与 OHCA 晚期持续 ROSC 发生率的增加可能存在关联。
