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Published on: October 24, 2018
Hyperoxia and mortality in conventional versus extracorporeal cardiopulmonary resuscitation
Sandra Emily Stoll1, Eldho Paul2, David Pilcher3
1Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, VIC, Australia; Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany.
Purpose:
Hyperoxia has been associated with adverse outcomes in post cardiac arrest (CA) patients. Study-objective was to examine the association between hyperoxia and 30-day mortality in a mixed cohort of two different modes of Cardiopulmonary Resuscitation (CPR): Extracorporeal (ECPR) vs. Conventional (CCPR).
Material And Methods:
In this retrospective cohort study of CA patients admitted to a tertiary level CA centre in Australia (over a 6.5-year time period) mean arterial oxygen levels (PaO2) and episodes of extreme hyperoxia (maximum of mean PaO2 ≥ 300 mmHg) were analysed over the first 8 days post CA.
Results:
One hundred and sixty-nine post CA patients were assessed (ECPR n = 79 / CCPR n = 90). Mean PaO2-levels were higher in the ECPR vs CCPR group (211 mmHg ± 58.4 vs 119 mmHg ± 18.1; p < 0.0001) as was the proportion with at least one episode of extreme hyperoxia (74.7% vs 16.7%; p < 0.001). After adjusting for confounders and the mode of CPR any episode of extreme hyperoxia was independently associated with a 2.52-fold increased risk of 30-day mortality (OR: 2.52, 95% CI: 1.06-5.98; p = 0.036).
Conclusions:
We found extreme hyperoxia was more common in ECPR patients in the first 8 days post CA and independently associated with higher 30-day mortality, irrespective of the CPR-mode.
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