Association of Pediatric Post-Cardiac Arrest Ventilation and Oxygenation with Survival Outcomes
RATIONALE: Adult and pediatric studies provide conflicting data whether post-cardiac arrest hypoxemia, hyperoxemia, hypercapnia and/or hypocapnia are associated with worse outcomes.
OBJECTIVES: Determine if post-arrest hypoxemia or post-arrest hyperoxemia are associated with lower rates of survival to hospital discharge compared to post-arrest normoxemia, and if post-arrest hypocapnia or hypercapnia are associated with lower rates of survival compared to post-arrest normocapnia.
METHODS: Embedded prospective observational study during a multi-center interventional cardiopulmonary resuscitation trial from 2016-2021. Patients ≤18 years and ≥37 weeks corrected gestational age who received chest compressions for cardiac arrest in one of 18 ICUs were included. Exposures during the first 24 hours post-arrest were hypoxemia, hyperoxemia, or normoxemia defined as lowest PaO2 <60mmHg, highest PaO2 ≥200mmHg, or every PaO2 60-199mmHg, respectively, and hypocapnia, hypercapnia, or normocapnia defined as lowest PaCO2 <30mmHg, highest PaCO2 ≥50mmHg, or every PaCO2 30-49mmHg, respectively. Associations of oxygenation and carbon dioxide group with survival to hospital discharge were assessed using Poisson regression with robust error estimates.
MEASUREMENTS AND MAIN RESULTS: The hypoxemia group was less likely to survive to hospital discharge compared with the normoxemia group (aRR 0.71, 0.58-0.87), whereas the hyperoxemia group survival did not differ from the normoxemia group (aRR 1.0, 0.87-1.15). The hypercapnia group was less likely to survive to hospital discharge compared with the normocapnia group (aRR 0.74, 0.64-0.84), whereas the hypocapnia group survival did not differ from the normocapnia group (aRR 0.91, 0.74-1.12).
CONCLUSIONS: Post-arrest hypoxemia and hypercapnia were each associated with lower rates of survival to hospital discharge.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Annals of the American Thoracic Society - (2024) vom: 20. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Frazier, Aisha H [VerfasserIn] |
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Date Revised 20.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1513/AnnalsATS.202311-948OC |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369972236 |
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| 100 | 1 | |a Frazier, Aisha H |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association of Pediatric Post-Cardiac Arrest Ventilation and Oxygenation with Survival Outcomes |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 20.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a RATIONALE: Adult and pediatric studies provide conflicting data whether post-cardiac arrest hypoxemia, hyperoxemia, hypercapnia and/or hypocapnia are associated with worse outcomes | ||
| 520 | |a OBJECTIVES: Determine if post-arrest hypoxemia or post-arrest hyperoxemia are associated with lower rates of survival to hospital discharge compared to post-arrest normoxemia, and if post-arrest hypocapnia or hypercapnia are associated with lower rates of survival compared to post-arrest normocapnia | ||
| 520 | |a METHODS: Embedded prospective observational study during a multi-center interventional cardiopulmonary resuscitation trial from 2016-2021. Patients ≤18 years and ≥37 weeks corrected gestational age who received chest compressions for cardiac arrest in one of 18 ICUs were included. Exposures during the first 24 hours post-arrest were hypoxemia, hyperoxemia, or normoxemia defined as lowest PaO2 <60mmHg, highest PaO2 ≥200mmHg, or every PaO2 60-199mmHg, respectively, and hypocapnia, hypercapnia, or normocapnia defined as lowest PaCO2 <30mmHg, highest PaCO2 ≥50mmHg, or every PaCO2 30-49mmHg, respectively. Associations of oxygenation and carbon dioxide group with survival to hospital discharge were assessed using Poisson regression with robust error estimates | ||
| 520 | |a MEASUREMENTS AND MAIN RESULTS: The hypoxemia group was less likely to survive to hospital discharge compared with the normoxemia group (aRR 0.71, 0.58-0.87), whereas the hyperoxemia group survival did not differ from the normoxemia group (aRR 1.0, 0.87-1.15). The hypercapnia group was less likely to survive to hospital discharge compared with the normocapnia group (aRR 0.74, 0.64-0.84), whereas the hypocapnia group survival did not differ from the normocapnia group (aRR 0.91, 0.74-1.12) | ||
| 520 | |a CONCLUSIONS: Post-arrest hypoxemia and hypercapnia were each associated with lower rates of survival to hospital discharge | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Topjian, Alexis A |e verfasserin |4 aut | |
| 700 | 1 | |a Reeder, Ron W |e verfasserin |4 aut | |
| 700 | 1 | |a Morgan, Ryan W |e verfasserin |4 aut | |
| 700 | 1 | |a Fink, Ericka L |e verfasserin |4 aut | |
| 700 | 1 | |a Franzon, Deborah |e verfasserin |4 aut | |
| 700 | 1 | |a Graham, Kathryn |e verfasserin |4 aut | |
| 700 | 1 | |a Harding, Monica L |e verfasserin |4 aut | |
| 700 | 1 | |a Mourani, Peter M |e verfasserin |4 aut | |
| 700 | 1 | |a Nadkarni, Vinay M |e verfasserin |4 aut | |
| 700 | 1 | |a Wolfe, Heather A |e verfasserin |4 aut | |
| 700 | 1 | |a Ahmed, Tageldin |e verfasserin |4 aut | |
| 700 | 1 | |a Bell, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Burns, Candice |e verfasserin |4 aut | |
| 700 | 1 | |a Carcillo, Joseph A |e verfasserin |4 aut | |
| 700 | 1 | |a Carpenter, Todd C |e verfasserin |4 aut | |
| 700 | 1 | |a Diddle, J Wesley |e verfasserin |4 aut | |
| 700 | 1 | |a Federman, Myke |e verfasserin |4 aut | |
| 700 | 1 | |a Friess, Stuart H |e verfasserin |4 aut | |
| 700 | 1 | |a Hall, Mark |e verfasserin |4 aut | |
| 700 | 1 | |a Hehir, David A |e verfasserin |4 aut | |
| 700 | 1 | |a Horvat, Christopher M |e verfasserin |4 aut | |
| 700 | 1 | |a Huard, Leanna L |c MD |e verfasserin |4 aut | |
| 700 | 1 | |a Maa, Tensing |e verfasserin |4 aut | |
| 700 | 1 | |a Meert, Kathleen L |e verfasserin |4 aut | |
| 700 | 1 | |a Naim, Maryam Y |e verfasserin |4 aut | |
| 700 | 1 | |a Notterman, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Pollack, Murray M |e verfasserin |4 aut | |
| 700 | 1 | |a Schneiter, Carleen |e verfasserin |4 aut | |
| 700 | 1 | |a Sharron, Matthew P |e verfasserin |4 aut | |
| 700 | 1 | |a Srivastava, Neeraj |e verfasserin |4 aut | |
| 700 | 1 | |a Viteri, Shirley |e verfasserin |4 aut | |
| 700 | 1 | |a Wessel, David |e verfasserin |4 aut | |
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| 700 | 1 | |a Sutton, Robert M |e verfasserin |4 aut | |
| 700 | 1 | |a Berg, Robert A |e verfasserin |4 aut | |
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