Sintrirat Purich, Vattanavanit Veerapong
Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
Critical Care Medicine Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
Open Access Emerg Med. 2025 Aug 21;17:233-245. doi: 10.2147/OAEM.S511715. eCollection 2025.
This study aimed to explore alterations in respiratory drive in comatose patients after out-of-hospital cardiac arrest (OHCA) and their association with survival outcomes.
A prospective cohort study was conducted on comatose patients with OHCA who were admitted between October 2022 and October 2024. Patients were followed until their discharge from the hospital and subsequently categorized into survivors and non-survivors. Respiratory drive was evaluated using P0.1, representing the airway occlusion pressure measured within the first 100 ms of inspiration, as displayed on the ventilator. Measurements were collected together with additional parameters at 24, 48, and 72 h following admission.
The analysis involved 30 patients, with an in-hospital mortality rate of 53.3%. Over the 72-h observation period, P0.1 values were greater in survivors than in non-survivors; however, this difference was not statistically significant. During the first 24 h, survivors demonstrated significantly lower tidal volumes per predicted body weight (P = 0.034). P0.1 values ranging from 1.5 to 3.5 cmHO in the initial 24 h were independently associated with reduced in-hospital mortality (adjusted OR 0.043, 95% CI 0.003-0.588, P = 0.018).
A trend toward elevated P0.1 levels in survivors was observed. P0.1 values within the range of 1.5-3.5 cmHO during the first 24 h were linked to a lower mortality rate. These results indicate that P0.1 could be utilized as a prognostic indicator for comatose patients following OHCA.
本研究旨在探讨院外心脏骤停（OHCA）后昏迷患者呼吸驱动的变化及其与生存结局的关联。
对2022年10月至2024年10月收治的OHCA昏迷患者进行了一项前瞻性队列研究。对患者进行随访直至出院，随后分为幸存者和非幸存者。使用P0.1评估呼吸驱动，P0.1代表呼吸机显示的吸气开始后100毫秒内测量的气道闭塞压。在入院后24、48和72小时收集测量数据以及其他参数。
分析涉及30例患者，院内死亡率为53.3%。在72小时的观察期内，幸存者的P0.1值高于非幸存者；然而，这种差异无统计学意义。在最初的24小时内，幸存者每预测体重的潮气量显著更低（P = 0.034）。最初24小时内P0.1值在1.5至3.5 cmH₂O之间与院内死亡率降低独立相关（调整后的OR为0.043，95%CI为0.003 - 0.588，P = 0.018）。
观察到幸存者有P0.1水平升高的趋势。最初24小时内P0.1值在1.5 - 3.5 cmH₂O范围内与较低的死亡率相关。这些结果表明，P0.1可作为OHCA后昏迷患者的预后指标。
