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Roberts BW, Kilgannon JH, Chansky ME, et al. Association between initial prescribed minute ventilation and post-resuscitation partial pressure of arterial carbon dioxide in patients with post-cardiac arrest syndrome. Ann Intensive Care. 2014;4(1):9doi: 10.1186/2110-5820-4-9.
Roberts, B. W., Kilgannon, J. H., Chansky, M. E., & Trzeciak, S. (2014). Association between initial prescribed minute ventilation and post-resuscitation partial pressure of arterial carbon dioxide in patients with post-cardiac arrest syndrome. Annals of intensive care, 4(1), 9. https://doi.org/10.1186/2110-5820-4-9
Roberts, Brian W, et al. "Association between initial prescribed minute ventilation and post-resuscitation partial pressure of arterial carbon dioxide in patients with post-cardiac arrest syndrome." Annals of intensive care vol. 4,1 (2014): 9. doi: https://doi.org/10.1186/2110-5820-4-9
Roberts BW, Kilgannon JH, Chansky ME, Trzeciak S. Association between initial prescribed minute ventilation and post-resuscitation partial pressure of arterial carbon dioxide in patients with post-cardiac arrest syndrome. Ann Intensive Care. 2014 Mar 07;4(1):9. doi: 10.1186/2110-5820-4-9. PMID: 24602367; PMCID: PMC3973966.
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Ann Intensive Care. 2014 Mar 07;4(1):9. doi: 10.1186/2110-5820-4-9.

Association between initial prescribed minute ventilation and post-resuscitation partial pressure of arterial carbon dioxide in patients with post-cardiac arrest syndrome.

Annals of intensive care

Brian W Roberts, J Hope Kilgannon, Michael E Chansky, Stephen Trzeciak

Affiliations

  1. The Department of Emergency Medicine, Cooper University Hospital, Cooper Medical School of Rowan University, One Cooper Plaza, K152, Camden, NJ 08103, USA. [email protected].

PMID: 24602367 PMCID: PMC3973966 DOI: 10.1186/2110-5820-4-9

Abstract

BACKGROUND: Post-cardiac arrest hypocapnia/hypercapnia have been associated with poor neurological outcome. However, the impact of arterial carbon dioxide (CO2) derangements during the immediate post-resuscitation period following cardiac arrest remains uncertain. We sought to test the correlation between prescribed minute ventilation and post-resuscitation partial pressure of CO2 (PaCO2), and to test the association between early PaCO2 and neurological outcome.

METHODS: We retrospectively analyzed a prospectively compiled single-center cardiac arrest registry. We included adult (age ≥ 18 years) patients who experienced a non-traumatic cardiac arrest and required mechanical ventilation. We analyzed initial post-resuscitation ventilator settings and initial arterial blood gas analysis (ABG) after initiation of post-resuscitation ventilator settings. We calculated prescribed minute ventilation:MVmL/kg/min=tidalvolumeTV/idealbodyweightIBWxrespiratoryrateRRfor each patient. We then used Pearson's correlation to test the correlations between prescribed MV and PaCO2. We also determined whether patients had normocapnia (PaCO2 between 30 and 50 mmHg) on initial ABG and tested the association between normocapnia and good neurological function (Cerebral Performance Category 1 or 2) at hospital discharge using logistic regression analyses.

RESULTS: Seventy-five patients were included. The majority of patients were in-hospital arrests (85%). Pulseless electrical activity/asystole was the initial rhythm in 75% of patients. The median (IQR) TV, RR, and MV were 7 (7 to 8) mL/kg, 14 (14 to 16) breaths/minute, and 106 (91 to 125) mL/kg/min, respectively. Hypocapnia, normocapnia, and hypercapnia were found in 15%, 62%, and 23% of patients, respectively. Good neurological function occurred in 32% of all patients, and 18%, 43%, and 12% of patients with hypocapnia, normocapnia, and hypercapnia respectively. We found prescribed MV had only a weak correlation with initial PaCO2, R = -0.40 (P < 0.001). Normocapnia was associated with good neurological function, odds ratio 4.44 (95% CI 1.33 to 14.85).

CONCLUSIONS: We found initial prescribed MV had only a weak correlation with subsequent PaCO2 and that early Normocapnia was associated with good neurological outcome. These data provide rationale for future research to determine the impact of PaCO2 management during mechanical ventilation in post-cardiac arrest patients.

References

  1. Ann Intern Med. 1972 Feb;76(2):328 - PubMed
  2. N Engl J Med. 2000 May 4;342(18):1301-8 - PubMed
  3. N Engl J Med. 2002 Feb 21;346(8):557-63 - PubMed
  4. Resuscitation. 2008 Dec;79(3):410-6 - PubMed
  5. Lancet. 1975 Mar 1;1(7905):480-4 - PubMed
  6. Circulation. 2004 Nov 23;110(21):3385-97 - PubMed
  7. Crit Care Med. 2000 Aug;28(8):2873-80 - PubMed
  8. Crit Care Clin. 1997 Jan;13(1):163-84 - PubMed
  9. Crit Care Med. 2013 Jun;41(6):1492-501 - PubMed
  10. Am Rev Respir Dis. 1981 Jun;123(6):659-64 - PubMed
  11. Crit Care Med. 2006 Apr;34(4):1202-8 - PubMed
  12. Tohoku J Exp Med. 2004 Apr;202(4):265-73 - PubMed
  13. Circulation. 2010 Nov 2;122(18 Suppl 3):S768-86 - PubMed
  14. Stroke. 1996 Jan;27(1):105-13 - PubMed
  15. Emerg Med J. 2011 May;28(5):432-6 - PubMed
  16. Resuscitation. 2012 Dec;83(12):1456-61 - PubMed
  17. Intensive Care Med. 2006 Jan;32(1):24-33 - PubMed
  18. Acta Physiol Scand. 1983 Jul;118(3):281-91 - PubMed
  19. Circulation. 2008 Dec 2;118(23):2452-83 - PubMed
  20. Resuscitation. 2009 Sep;80(9):990-3 - PubMed
  21. Stroke. 1997 Aug;28(8):1569-73 - PubMed
  22. Anesthesiology. 1998 May;88(5):1365-86 - PubMed
  23. Stroke. 1975 Jul-Aug;6(4):425-31 - PubMed
  24. Resuscitation. 2009 Jun;80(6):617-23 - PubMed
  25. N Engl J Med. 2013 Dec 5;369(23):2197-206 - PubMed
  26. Circulation. 2013 May 28;127(21):2107-13 - PubMed
  27. Acta Neurochir Suppl. 1998;71:1-4 - PubMed
  28. Crit Care Med. 2009 Nov;37(11):2895-903; quiz 2904 - PubMed
  29. JAMA. 2006 Jan 4;295(1):50-7 - PubMed
  30. N Engl J Med. 1991 May 2;324(18):1225-31 - PubMed
  31. Resuscitation. 2003 Mar;56(3):247-63 - PubMed
  32. Bull Eur Physiopathol Respir. 1982 May-Jun;18(3):419-25 - PubMed
  33. J Trauma Acute Care Surg. 2012 Apr;72(4):844-51 - PubMed
  34. J Neurosurg. 1991 Nov;75(5):731-9 - PubMed
  35. Resuscitation. 2005 Sep;66(3):317-21 - PubMed
  36. Pediatrics. 1995 Jun;95(6):868-74 - PubMed
  37. Br Med J. 1971 Jul 3;3(5765):7-9 - PubMed
  38. Resuscitation. 1996 Oct;32(3):169-76 - PubMed
  39. Acta Paediatr Scand. 1987 May;76(3):401-4 - PubMed
  40. Crit Care Med. 2000 Aug;28(8):2866-72 - PubMed
  41. Acad Emerg Med. 2006 May;13(5):530-6 - PubMed
  42. Resuscitation. 2003 Sep;58(3):297-308 - PubMed
  43. Resuscitation. 2005 Sep;66(3):271-83 - PubMed
  44. Resuscitation. 2013 Jul;84(7):927-34 - PubMed
  45. N Engl J Med. 2002 Feb 21;346(8):549-56 - PubMed

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