Usefulness of chloride levels for fluid resuscitation in patients undergoing targeted temperature management after out-of-hospital cardiac arrest

Association of point‐of‐care blood variables obtained from dogs and cats during cardiopulmonary resuscitation and following return of spontaneous circulation with patient outcomes

“…An increased chloride concentration measured on first blood sample following ROSC was significantly associated with decreased odds of survival to hospital discharge, with every 1 mmol/L (mEq/L) making survival 19% less likely. In people suffering out‐of‐hospital CPA, rates of poor neurological outcomes are significantly higher in hypochloremic and hyperchloremic patients than in normochloremic patients, and poor neurological outcomes were significantly associated with each 1 mmol/L (mEq/L) increase in chloride concentration in nonhypochloremic patients 72 . Increases in chloride concentrations are thought to contribute to metabolic acidosis and renal vasoconstriction, which might explain the association with less favorable patient outcomes, and a similar mechanism likely contributes to increases in morbidity in critically ill dogs and cats 72,73 .…”

“…In people suffering out-ofhospital CPA, rates of poor neurological outcomes are significantly higher in hypochloremic and hyperchloremic patients than in normochloremic patients, and poor neurological outcomes were significantly associated with each 1 mmol/L (mEq/L) increase in chloride concentration in nonhypochloremic patients. 72 Increases in chloride concentrations are thought to contribute to metabolic acidosis and renal vasoconstriction, which might explain the association with less favorable patient outcomes, and a similar mechanism likely contributes to increases in morbidity in critically ill dogs and cats. 72,73 In the current study, post-CPA care and neurological function scoring were not standardized, and larger, prospective studies are needed to better understand the influence of chloride concentration and concentration changes over time on survival and functional outcome in dogs and cats following CPR.…”

“…72 Increases in chloride concentrations are thought to contribute to metabolic acidosis and renal vasoconstriction, which might explain the association with less favorable patient outcomes, and a similar mechanism likely contributes to increases in morbidity in critically ill dogs and cats. 72,73 In the current study, post-CPA care and neurological function scoring were not standardized, and larger, prospective studies are needed to better understand the influence of chloride concentration and concentration changes over time on survival and functional outcome in dogs and cats following CPR.…”