Association between intra- and post-arrest hyperoxia on mortality in adults with cardiac arrest: A systematic review...

The association between intra-arrest and post-arrest hyperoxia and mortality in adults with cardiac arrest (CA) is widely debated. We therefore conducted a systematic review and meta-analysis to investigate the association between intra-arrest and post-arrest hyperoxia and mortality in adults with CA.

We systematically searched MEDLINE and Cochrane databases to identify observational studies from January 2008 to December 2017 investigating the relationship between hyperoxia (either intra-arrest or post-arrest) and mortality in adults with CA.

We included 16 observational studies with a total of 40,573 adult patients. Six studies included patients only with out-of-hospital CA (OHCA), 2 studies included patients only with in-hospital CA (IHCA), and 8 studies included patients with both OHCA and IHCA. Two studies assessed intra-arrest hyperoxia while 14 studies examined post-arrest hyperoxia. Of the 10 studies included for quantitative analysis, intra-arrest hyperoxia was associated with a significantly lower mortality rate [odds ratio (OR) 0.25, 95% confidence interval (CI) 0.12-0.53, p < 0.001] while post-arrest hyperoxia was associated with higher mortality (OR 1.34, 95%CI 1.08-1.67, p = 0.008).

In adults with CA, intra-arrest hyperoxia is associated with lower mortality while post-arrest hyperoxia is associated with higher mortality.