Comparison of 30 and the 100% inspired oxygen concentrations during early post-resuscitation period: a randomised controlled pilot study

Kuisma, Markku; Boyd, James; Voipio, Ville; Alaspää, Ari; Roine, Risto O.; Rosenberg, P. H.

doi:10.1016/j.resuscitation.2005.08.010

Cited by 153 publications

(107 citation statements)

References 14 publications

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“…[82][83][84][85][86][87] One randomized prospective clinical trial compared ventilation for the first 60 minutes after ROSC with 30% oxygen (resulting in PaO 2 ϭ110Ϯ25 mm Hg at 60 minutes) or 100% oxygen (resulting in PaO 2 ϭ345Ϯ174 mm Hg at 60 minutes). 88 This small trial detected no difference in serial markers of acute brain injury, survival to hospital discharge, or percentage of patients with good neurological outcome at hospital discharge but was inadequately powered to detect important differences in survival or neurological outcome.…”

Section: Pulmonary Systemmentioning

confidence: 94%

Part 9: Post–Cardiac Arrest Care

Peberdy¹,

Callaway²,

Neumar³

et al. 2010

Circulation

1,451

838

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Section: Pulmonary Systemmentioning

confidence: 94%

Part 9: Post–Cardiac Arrest Care

Peberdy¹,

Callaway²,

Neumar³

et al. 2010

Circulation

1,451

838

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“…5,6 We chose to use only the first arterial blood gas taken within 1 hour of contact with the PICU or retrieval team to investigate the effect of hyperoxia early after reperfusion. Laboratory data 5,6 and a preliminary clinical study 26 support the concept of harm from supranormal oxygen tension in the first hour after return of circulation. It is unknown whether more prolonged exposure to hyperoxia would increase the risk of death further.…”

Section: Discussionmentioning

confidence: 70%

Relationship Between Arterial Partial Oxygen Pressure After Resuscitation From Cardiac Arrest and Mortality in Children

2012

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Background-Observational studies in adults have shown a worse outcome associated with hyperoxia after resuscitation from cardiac arrest. Extrapolating from adult data, current pediatric resuscitation guidelines recommend avoiding hyperoxia. We investigated the relationship between arterial partial oxygen pressure and survival in patients admitted to the pediatric intensive care unit (PICU) after cardiac arrest. Methods and Results-We conducted a retrospective cohort study using the Pediatric Intensive Care Audit Network (PICANet) database between 2003 and 2010 (nϭ122 521). Patients aged Ͻ16 years with documented cardiac arrest preceding PICU admission and arterial blood gas analysis taken within 1 hour of PICU admission were included. The primary outcome measure was death within the PICU. The relationship between postarrest oxygen status and outcome was modeled with logistic regression, with nonlinearities explored via multivariable fractional polynomials. Covariates included age, sex, ethnicity, congenital heart disease, out-of-hospital arrest, year, Pediatric Index of Mortality-2 (PIM2) mortality risk, and organ supportive therapies. Of 1875 patients, 735 (39%) died in PICU. Based on the first arterial gas, 207 patients (11%) had hyperoxia (PaO 2 Ն300 mm Hg) and 448 (24%) had hypoxia (PaO 2 Ͻ60 mm Hg). We found a significant nonlinear relationship between PaO 2 and PICU mortality. After covariate adjustment, risk of death increased sharply with increasing hypoxia (odds ratio, 1.92; 95% confidence interval, 1.80 -2.21 at PaO 2 of 23 mm Hg). There was also an association with increasing hyperoxia, although not as dramatic as that for hypoxia (odds ratio, 1.25; 95% confidence interval, 1.17-1.37 at 600 mm Hg). We observed an increasing mortality risk with advancing age, which was more pronounced in the presence of congenital heart disease. Conclusions-Both severe hypoxia and, to a lesser extent, hyperoxia are associated with an increased risk of death after PICU admission after cardiac arrest. (Circulation. 2012;126:335-342.)

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“…770 Mean partial pressure of oxygen in arterial blood (PaO 2 ) at 60 minutes after ROSC was 14.6Ϯ3.3 kPa (110Ϯ25 mm Hg) in the 30% oxygen group and 46.5Ϯ23.2 (343Ϯ174 mm Hg) in the 100% oxygen group. No statistical difference was detected in serum biomarkers of acute brain injury, survival to hospital discharge, or the percent of patients with good neurological outcome (cerebral performance category of 1 or 2) at hospital discharge.…”

Section: Consensus On Sciencementioning

confidence: 96%