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Hyperoxia and the Post-Arrest Patient
- Current post-arrest guideilnes recommend titrating supplemental O2 to avoid hypoxia and limit exposure to hyperoxia.
- Importantly, these recommendations are based primarily on retrospective studies that have used ABG values within the first 24 hours following ROSC.
- The latest study to evaluate the impact of hyperoxia following cardiac arrest was just published in Circulation.
- This study is a prospective, cohort study that evaluated the association between early hyperoxia and poor neurologic outcome in adults following cardiac arrest. (ABGs were obtained at 1 hour and 6 hours following ROSC)
- Of 280 patients, 38% were exposed to early hyperoxia (defined as a PaO2 > 300 mm Hg)
- Take Home Points
- Early hyperoxia was found to be an independent predictor of poor neurologic outcome at hospital discharge.
- One hour longer duration of hyperoxia was associated with a 3% increase in the risk of poor neurologic outcome
- SaO2 could not reliably exclude the presence of hyperoxia.
References
Roberts BW, et al. Association between early hyperoxia exposure after resuscitation from cardiac arrest and neurological disability: a prospective multi-center protocol-directed cohort study. Circulation 2018; epub ahead of print.