Increasing arterial oxygen partial pressure during cardiopulmonary resuscitation is associated with improved rates of hospital admission

Spindelboeck, Walter; Schindler, Otmar; Moser, Adrian; Hausler, Florian; Wallner, Simon; Strasser, Christa; Haas, Josef; Gemes, Geza; Prause, Gerhard

doi:10.1016/j.resuscitation.2013.01.012

Cited by 100 publications

(78 citation statements)

References 25 publications

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“…However, 1 observational study of 145 OHCA patients evaluated arterial Po 2 measured during CPR and cardiac arrest outcomes. 5 In this study, during which all patients received maximal inspired oxygen concentration, patients were divided into low, intermediate, and high arterial Po 2 ranges (less than 61, 61-300, and greater than 300 mm Hg, respectively). The higher ranges of arterial Po 2 during CPR were associated with an increase in hospital admission rates (low, 18.8%; intermediate, 50.6%; and high, 83.3%).…”

Section: Evidence Summarymentioning

confidence: 99%

Part 7: Adult Advanced Cardiovascular Life Support

Link¹,

Berkow²,

Kudenchuk³

et al. 2015

Circulation

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429

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Section: Evidence Summarymentioning

confidence: 99%

Part 7: Adult Advanced Cardiovascular Life Support

Link¹,

Berkow²,

Kudenchuk³

et al. 2015

Circulation

1,049

429

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“…For the critical outcome of survival to hospital discharge with favorable neurologic outcome (Cerebral Performance Category [CPC] 1 or 2), we identified very-low-quality evidence (downgraded for very serious risk of bias, very serious indirectness, and serious imprecision) from 1 observational study 22 For the important outcome of ROSC, we identified verylow-quality evidence (downgraded for very serious risk of bias, very serious indirectness, and serious imprecision) from 1 observational study 22 In the single identified study, 22 all patients had tracheal intubation and received 100% inspired oxygen during CPR. The worse outcomes associated with a low Pao 2 during CPR could be an indication of illness severity.…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 4: Advanced Life Support

Nolan¹,

Hazinski²,

Aickin³

et al. 2015

Circulation

554

125

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Questions to be addressed (using the PICO [population, intervention, comparator, outcome] format) 3 were prioritized by ALS Task Force members (by voting). Prioritization criteria included awareness of significant new data and new controversies or questions about practice. Questions about topics no longer relevant to contemporary practice or where little new research has occurred were given lower priority. The ALS Task Force prioritized 42 PICO questions for review. With the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evaluation. The reviewers for each question created a reconciled risk of bias assessment for each of the included studies, using state-of-the-art tools: Cochrane for randomized controlled trials (RCTs), 4 Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 for studies of diagnostic accuracy, 5 and GRADE for observational studies that inform both therapy and prognosis questions. 6 GRADE evidence profile tables 7 were then created to facilitate an evaluation of the evidence in support of each of the critical and important outcomes. The quality of the evidence (or confidence in the estimate of the effect) was categorized as high, moderate, low, or very low, 8 based on the study methodologies and the 5 core GRADE domains of risk of bias, inconsistency, indirectness, imprecision, and other considerations (including publication bias). 9 These evidence profile tables were then used to create a written summary of evidence for each outcome (the consensus on science statements). Whenever possible, consensus-based treatment recommendations were then created. These recommendations (designated as strong or weak) were accompanied by an overall assessment of the evidence and a statement from the task force about the values, preferences, and task force insights that underlie the recommendations. Further details of the methodology that underpinned the evidence evaluation process are found in "Part 2: Evidence Evaluation and Management of Conflicts of Interest."The task force preselected and ranked outcome measures that were used as consistently as possible for all PICO questions. Longer-term, patient-centered outcomes were considered more important than process variables and shorter-term outcomes. For most questions, we used the following hierarchy starting with the most important: long-term survival with neurologically favorable survival, long-term survival, short-term survival, and process variable. In general, longterm was defined as from hospital discharge to 180 days or longer, and short-term was defined as shorter than to hospital discharge. For certain questions (eg, related to defibrillation or confirmation of tracheal tube position), process variables such as termination of fibrillation and correct tube placement were important. A few questions (eg, organ donation) required unique outcomes....

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“…In a retrospective study, Spindelboeck and colleagues investigated the association between arterial oxygen during CPR and hospital admission rates after OHCA. 17 They analysed ABG samples obtained within 60 minutes of the initiation of chest compression in patients that were intubated and ventilated with 100% oxygen and receiving manual chest compressions. They found higher PaO2 values to be associated with an increased rate of hospital admission, but the patient sample size was underpowered for analysis of the neurologic outcome.…”

Section: Discussionmentioning

confidence: 99%

“…17 Also the arterial carbon dioxide was high during CPR which might increase cerebral blood flow through cerebral vasodilatation and influence cerebral oxygenation. NIRS is feasible for monitoring of regional brain saturation in humans, but anatomical differences in the thickness of the forehead between pigs and humans might affect this value.…”

Section: Discussionmentioning

confidence: 99%

The effect of 50% compared to 100% inspired oxygen fraction on brain oxygenation and post cardiac arrest mitochondrial function in experimental cardiac arrest

et al. 2017

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The use of 50% oxygen during CPR results in lower cerebral oximetry values compared to 100% oxygen but there is no difference in brain tissue oxygen. Cardiac arrest disturbs cardiac mitochondrial respiration, but it is not alleviated with the use of 50% compared to 100% oxygen (Ethical and hospital approvals ESAVI/1077/04.10.07/2016 and HUS/215/2016, §7 30.3.2016, Funding Helsinki University and others).

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Increasing arterial oxygen partial pressure during cardiopulmonary resuscitation is associated with improved rates of hospital admission

Cited by 100 publications

References 25 publications

Part 7: Adult Advanced Cardiovascular Life Support

Part 7: Adult Advanced Cardiovascular Life Support

Part 4: Advanced Life Support

The effect of 50% compared to 100% inspired oxygen fraction on brain oxygenation and post cardiac arrest mitochondrial function in experimental cardiac arrest

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