Early blood pH as an independent predictor of neurological outcome in patients with out-of-hospital cardiac arrest: A retrospective observational study.

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Tytuł:: Early blood pH as an independent predictor of neurological outcome in patients with out-of-hospital cardiac arrest: A retrospective observational study.
Autorzy:: Lin CH; School of Medicine, College of Medicine, China Medical University.; Department of Emergency Medicine, China Medical University Hospital.
Yu SH; Department of Emergency Medicine, China Medical University Hospital.; Graduate Institute of Biomedical Sciences.
Chen CY; School of Medicine, College of Medicine, China Medical University.
Huang FW; Department of Emergency Medicine, China Medical University Hospital.
Chen WK; School of Medicine, College of Medicine, China Medical University.; Department of Emergency Medicine, China Medical University Hospital.
Shih HM; School of Medicine, College of Medicine, China Medical University.; Department of Emergency Medicine, China Medical University Hospital.; Department of Public Health, China Medical University, Taichung, Taiwan.
Źródło:: Medicine [Medicine (Baltimore)] 2021 Apr 30; Vol. 100 (17), pp. e25724.
Typ publikacji:: Journal Article; Observational Study
Język:: English
Imprint Name(s):: Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins
MeSH Terms:: Acidosis*/diagnosis
Acidosis*/etiology
Blood Gas Analysis*/methods
Blood Gas Analysis*/statistics & numerical data
Emergency Medical Services*/methods
Emergency Medical Services*/statistics & numerical data
Nervous System Diseases*/diagnosis
Nervous System Diseases*/epidemiology
Nervous System Diseases*/etiology
Out-of-Hospital Cardiac Arrest*/blood
Out-of-Hospital Cardiac Arrest*/complications
Out-of-Hospital Cardiac Arrest*/epidemiology
Out-of-Hospital Cardiac Arrest*/therapy
Cardiopulmonary Resuscitation/*methods
Aged ; Cardiopulmonary Resuscitation/standards ; Female ; Humans ; Hydrogen-Ion Concentration ; Male ; Neurologic Examination/methods ; Neurologic Examination/statistics & numerical data ; Outcome and Process Assessment, Health Care ; Prognosis ; Taiwan/epidemiology ; Tertiary Care Centers ; Time-to-Treatment/statistics & numerical data
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Grant Information:: MOST 107-2314-B-039-054-MY2 Ministry of Science and Technology, Taiwan (TW); MOHW107-TDU-B-212-123004 Health Promotion Administration, Ministry of Health and Welfare (TW); DMR-109-057 China Medical University Hospital; DMR-107-060 China Medical University Hospital
Entry Date(s):: Date Created: 20210428 Date Completed: 20210510 Latest Revision: 20230915
Update Code:: 20240105
PubMed Central ID:: PMC8084093
DOI:: 10.1097/MD.0000000000025724
PMID:: 33907164
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Abstract: Metabolic acidosis is observed in 98% of patients with out-of-hospital cardiac arrest (OHCA). The longer the no-flow or low-flow duration, the more severe is the acidosis in these patients. This study explored whether blood pH in early stages of advanced life support (ALS) was an independent predictor of neurological prognosis in patients with OHCA.We retrospectively enrolled patients with OHCA from January 2012 to June 2018 in a single-medical tertiary hospital in Taiwan. Patients with OHCA whose blood gas analyses within 5 minutes after receiving ALS at the emergency department (ED) were enrolled. Patients younger than 20 years old, with cardiac arrest resulting from traumatic or circumstantial causes, with return of spontaneous circulation (ROSC) before ED arrival, lacking record of initial blood gas analysis, and with do-not-resuscitate orders were excluded. The primary outcome of this study was neurological status at hospital discharge.In total, 2034 patients with OHCA were enrolled. The majority were male (61.89%), and the average age was 67.8 ± 17.0 years. Witnessed OHCA was noted in 571 cases, cardiopulmonary resuscitation was performed before paramedic arrival in 512 (25.2%) cases, and a shockable rhythm was observed in 269 (13.2%). Blood pH from initial blood gas analysis remained an independent predictor of neurological outcome after multivariate regression.Blood pH at early stages of ALS was an independent prognostic factor of post-OHCA neurological outcome. Blood gas analysis on arrival at the ED may provide additional information about the prognosis of patients with OHCA.
Competing Interests: The authors have no conflicts of interests to disclose.
(Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

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