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Cardiac power output is associated with cardiovascular related mortality in the ICU in post-cardiac arrest patients

Federica Magni1, Rossana Soloperto2, Anita Farinella3

  • 1Department of Intensive Care, Erasme Hospital, Lennik Road 808, 1070 Brussels, Belgium; University of Insubria, Via Ravasi 2, 21100 Varese, Italy.

Resuscitation
|November 29, 2023
PubMed

Insights

Cardiac power output (CPO) measured 8 hours after cardiac arrest (CA) is a key predictor of early cardiovascular-related death in intensive care units (ICUs). This finding helps identify patients at high risk for cardiovascular failure post-CA.

Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Cardiovascular Physiology

Background:

  • Cardiovascular failure is a leading cause of death after cardiac arrest (CA), despite brain injury being the primary determinant of poor outcomes.
  • Early identification of hemodynamic parameters predicting cardiovascular failure post-CA is crucial for timely intervention.
  • Cardiac power output (CPO) has emerged as a potential indicator of cardiovascular performance.

Purpose of the Study:

  • To investigate the association between cardiac power output (CPO) and early mortality in intensive care unit (ICU) patients following cardiac arrest (CA).
  • To determine if CPO can predict mortality specifically related to post-CA cardiovascular failure.
  • To identify the optimal timing for CPO measurement for early recognition of cardiovascular compromise.

Main Methods:

  • Retrospective analysis of adult comatose survivors of CA admitted to the ICU.
  • Exclusion of patients receiving extracorporeal cardiopulmonary resuscitation, ECMO, or intra-aortic balloon pump.
  • Recording of hemodynamic parameters including CPO at 8-hour intervals for the first 72 hours post-ROSC.

Main Results:

  • Among 217 patients, 142 died in the ICU, with 43 deaths attributed to cardiovascular causes.
  • A statistically significant difference in CPO between survivors and non-survivors was observed at 8 hours post-CA (p=0.0042).
  • Multivariable analysis revealed that CPO at 8 hours was significantly associated with cardiovascular-related mortality (p=0.007).

Conclusions:

  • Cardiac power output (CPO) measured 8 hours after cardiac arrest is an independent predictor of cardiovascular-related mortality in the ICU.
  • This finding highlights the utility of CPO as an early marker for cardiovascular compromise in post-CA patients.
  • The study emphasizes the importance of hemodynamic monitoring in the early management of CA survivors to mitigate cardiovascular failure.
Abstract

Keywords:
Cardiac arrestIschemia–reperfusionPost-cardiac arrest syndromePrognosis

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