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Intra-arrest blood-based biomarkers for out-of-hospital cardiac arrest: A scoping review
Justin L Benoit1, Andrew N Hogan2, Katherine M Connelly3
1Department of Emergency Medicine University of Cincinnati College of Medicine Cincinnati Ohio USA.
Insights
Research on blood biomarkers during out-of-hospital cardiac arrest (OHCA) is extensive, but methodological gaps persist. Few studies report completely, and prehospital sample collection is rare, limiting clinical application.
Area of Science:
- Critical Care Medicine
- Biomarker Research
- Emergency Medicine
Background:
- Blood-based biomarkers are crucial for critically ill patients.
- No biomarkers are routinely measured during the intra-arrest phase of out-of-hospital cardiac arrest (OHCA).
- Understanding current research is vital for advancing OHCA care.
Purpose of the Study:
- To describe methodological aspects of intra-arrest blood-based biomarker research in OHCA.
- To identify sources of evidence and research gaps.
- To inform future research directions in OHCA biomarker analysis.
Main Methods:
- Scoping review methodology adhering to PRISMA Extension for Scoping Reviews.
- Searched PubMed and Embase, supplemented by hand-searching secondary literature.
- Included peer-reviewed studies on OHCA patients with intra-arrest blood draws; excluded in-hospital arrests and animal studies.
Main Results:
- 118 studies evaluated 105 biomarkers; only 7% reported completely.
- Most studies originated from Asia (53%); only 19% collected samples pre-hospital.
- Prognostic (92%) and diagnostic (58%) uses were most common; pediatric data was scarce (3%).
Conclusions:
- Significant methodological and knowledge gaps exist despite a large volume of literature.
- Incomplete reporting and limited prehospital data hinder the clinical utility of intra-arrest biomarkers.
- Further research is needed to standardize methods and expand biomarker application in OHCA.
Objective:
Blood-based biomarkers play a central role in the diagnosis and treatment of critically ill patients, yet none are routinely measured during the intra-arrest phase of out-of-hospital cardiac arrest (OHCA). Our objective was to describe methodological aspects, sources of evidence, and gaps in research surrounding intra-arrest blood-based biomarkers for OHCA.
Methods:
We used scoping review methodology to summarize existing literature. The protocol was designed a priori following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. Inclusion criteria were peer-reviewed scientific studies on OHCA patients with at least one blood draw intra-arrest. We excluded in-hospital cardiac arrest and animal studies. There were no language, date, or study design exclusions. We conducted an electronic literature search using PubMed and Embase and hand-searched secondary literature. Data charting/synthesis were performed in duplicate using standardized data extraction templates.
Results:
The search strategy identified 11,834 records, with 118 studies evaluating 105 blood-based biomarkers included. Only eight studies (7%) had complete reporting. The median number of studies per biomarker was 2 (interquartile range 1-4). Most studies were conducted in Asia (63 studies, 53%). Only 22 studies (19%) had blood samples collected in the prehospital setting, and only six studies (5%) had samples collected by paramedics. Pediatric patients were included in only three studies (3%). Out of eight predefined biomarker categories of use, only two were routinely assessed: prognostic (97/105, 92%) and diagnostic (61/105, 58%).
Conclusions:
Despite a large body of literature on intra-arrest blood-based biomarkers for OHCA, gaps in methodology and knowledge are widespread.
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