Blood ammonia is a predictive biomarker of neurologic outcome in cardiac arrest patients treated with therapeutic hypothermia

Cho, Young Mo; Lim, Yong Su; Yang, Hyuk Jun; Park, Won Bin; Cho, Jin Seong; Kim, Jin Joo; Hyun, Sung Youl; Lee, Mi Jin; Kang, Young Joon; Lee, Gun

doi:10.1016/j.ajem.2011.10.009

Cited by 20 publications

(14 citation statements)

References 23 publications

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“…There have been previous studies on the relationship between laboratory test results during CPR and patient outcomes [ 3 , 4 , 16 , 17 ]. Most of those studies were performed after ROSC in OHCA patients [ 18 – 22 ].…”

Section: Discussionmentioning

confidence: 99%

Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicenter observational registry-based study

et al. 2017

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BackgroundWhen an out-of-hospital cardiac arrest (OHCA) patient receives cardiopulmonary resuscitation (CPR) in the emergency department (ED), blood laboratory test results can be obtained by using point-of-care testing during CPR. In the present study, the relationship between blood laboratory test results during CPR and outcomes of OHCA patients was investigated.MethodsThis study was a multicenter retrospective analysis of prospective registered data that included 2716 OHCA patients. Data from the EDs of three university hospitals in different areas were collected from January 2009 to December 2014. Univariate and multivariable analyses were conducted to elucidate the factors associated with survival to discharge and neurological outcomes. A final analysis was conducted by including patients who had no prehospital return of spontaneous circulation and those who underwent rapid blood laboratory examination during CPR.ResultsOverall, 2229 OHCA patients were included in the final analysis. Among them, the rate of survival to discharge and a good Cerebral Performance Categories Scale score were 14% and 4.4%, respectively. The pH level was independently related to survival to hospital discharge (adjusted OR 6.287, 95% CI 2.601–15.197; p < 0.001) and good neurological recovery (adjusted OR 15.395, 95% CI 3.439–68.911; p < 0.001). None of the neurologically intact patients had low pH levels (< 6.8) or excessive potassium levels (> 8.5 mEq/L) during CPR.ConclusionsAmong the blood laboratory test results during CPR of OHCA patients, pH and potassium levels were observed as independent factors associated with survival to hospital discharge, and pH level was considered as an independent factor related to neurological recovery.

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Section: Discussionmentioning

confidence: 99%

Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicenter observational registry-based study

et al. 2017

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“…Blood ammonia was associated with poor neurological outcomes in a patient population being treated with therapeutic hypothermia (Cho et al, 2012). Pulmonary arterial hypertension is a progressive …”

Section: Cardiovascular Markersmentioning

confidence: 99%

The Measurement of Ammonia in Human Breath and its Potential in Clinical Diagnostics

Brannelly

Shield

Killard

2016

Critical Reviews in Analytical Chemistry

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“…Early and effective clearance of serum lactate (i.e., lower levels) are associated with lower mortality in patients with many critical illnesses, including sepsis and severe trauma [13][14][15][16][17][18] . For cardiac arrest survivors, the relationships between clearance of serum lactate and neurological and survival outcomes have been studied [19][20][21][22][23] . However, few studies have addressed the potential relationship between initial serum levels of lactate and outcomes in patients who have been treated with TH.…”

Section: Introductionmentioning

confidence: 99%

Correlation between initial serum levels of lactate after return of spontaneous circulation and survival and neurological outcomes in patients who undergo therapeutic hypothermia after cardiac arrest

et al. 2015

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Blood ammonia is a predictive biomarker of neurologic outcome in cardiac arrest patients treated with therapeutic hypothermia

Cited by 20 publications

References 23 publications

Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicenter observational registry-based study

Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicenter observational registry-based study

The Measurement of Ammonia in Human Breath and its Potential in Clinical Diagnostics

Correlation between initial serum levels of lactate after return of spontaneous circulation and survival and neurological outcomes in patients who undergo therapeutic hypothermia after cardiac arrest

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