Journal article
Non-linear association between arterial oxygen tension and survival after out-of-hospital cardiac arrest: A multicentre observational study
Resuscitation, Vol.158, pp.P130-P138
2020
Abstract
Background
Studies to identify safe oxygenation targets after out-of-hospital cardiac arrest (OHCA) have often assumed a linear relationship between arterial oxygen tension (PaO2) and survival, or have dichotomised PaO2 at a supra-physiological level. We hypothesised that abnormalities in mean PaO2 (both high and low) would be associated with decreased survival after OHCA.
Methods
We conducted a retrospective multicentre cohort study of adult OHCA patients who received mechanical ventilation on admission to the intensive care unit (ICU). The potential non-linear relationship between the mean PaO2 within the first 24 -hs of ICU admission and survival to hospital discharge (STHD) was assessed by a four-knot restricted cubic spline function with adjustment for potential confounders.
Results
3764 arterial blood gas results were available for 491 patients in the first 24 -hs of ICU admission. The relationship between mean PaO2 over the first 24 -hs and STHD was an inverted U-shape, with highest survival for those with a mean PaO2 between 100 and 180 mmHg (reference category) compared to a mean PaO2 of <100 mmHg (adjusted odds ratio [aOR] 0.50 95% confidence interval [CI] 0.30, 0.84), or >180 mmHg (aOR 0.41, 95% CI 0.18, 0.92). Mean PaO2 within 24 -hs was the third most important predictor and explained 9.1% of the variability in STHD.
Conclusion
The mean PaO2 within the first 24-hs after admission for OHCA has a non-linear association with the highest STHD seen between 100 and 180 mmHg. Randomised controlled trials are now needed to validate the optimal oxygenation targets in mechanically ventilated OHCA patients.
Details
- Title
- Non-linear association between arterial oxygen tension and survival after out-of-hospital cardiac arrest: A multicentre observational study
- Authors/Creators
- N. Mckenzie (Author/Creator) - Royal Perth HospitalJ. Finn (Author/Creator) - The University of Western AustraliaG. Dobb (Author/Creator) - The University of Western AustraliaP. Bailey (Author/Creator) - Curtin UniversityG. Arendts (Author/Creator) - Fiona Stanley HospitalA. Celenza (Author/Creator) - Sir Charles Gairdner HospitalD. Fatovich (Author/Creator) - The University of Western AustraliaI. Jenkins (Author/Creator) - Fremantle HospitalS. Ball (Author/Creator) - Curtin UniversityJ. Bray (Author/Creator) - Monash UniversityK.M. Ho (Author/Creator) - The University of Western Australia
- Publication Details
- Resuscitation, Vol.158, pp.P130-P138
- Publisher
- Elsevier Ireland Ltd
- Identifiers
- 991005543397307891
- Copyright
- © 2020 Elsevier B.V.
- Murdoch Affiliation
- School of Veterinary Medicine
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
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- Citation topics
- 1 Clinical & Life Sciences
- 1.134 Trauma & Emergency Surgery
- 1.134.600 Cardiopulmonary Resuscitation
- Web Of Science research areas
- Critical Care Medicine
- Emergency Medicine
- ESI research areas
- Clinical Medicine