저체온치료를 받은 병원전 심정지 환자에서 비정상 이산화탄소분압과 예후와의 관계 The Association between Dyscarbia and Outcome in Out-of-hospital Cardiac Arrest Survivors Treated with Therapeutic Hypothermia
Purpose: There is a lack of clinical evidence in terms of theassociation between carbon dioxide tension and outcomes incardiac arrest survivors treated with therapeutic hypothermia(TH). We investigated the association of time-weighted meancarbon dioxide tension (TWMCO2) and outcomes in out-ofhospitalcardiac arrest (OHCA) survivors treated with TH.Methods: This was a retrospective cohort study including177 OHCA survivors. The patients were divided into threegroups according to the values of TWMCO2 (normocarbia,35~45 mmHg; hypocarbia, <35 mmHg; hypercarbia, >45mmHg). The primary outcome was in-hospital mortality andthe secondary outcome was neurologic outcome at discharge.We assessed neurologic outcome at hospital dischargeusing the Cerebral Performance Categories (CPC).Neurologic outcome was dichotomized as either good neurologicoutcome (CPC1 and CPC2) or poor neurologic outcome(CPC 3 to 5). The odds ratio with 95% confidenceinterval (CI) was estimated.Results: The median value of PaCO2 was 38.2 (33.9-43.3)mmHg. Among a total of 1,239 PaCO2 values, normocarbia,hypocarbia, and hypercarbia were 618 (49.8%), 380(30.7%), and 241 (19.5%), respectively. Results of univariatelogistic regression analysis showed that hypocarbia hada significantly high odds ratio for in-hospital mortality (2.474(95% CI, 1.129-5.424), p=0.024) compared with normocarbia.Results of multivariate logistic regression analysisshowed that hypocarbia (2.926; 95% CI, 1.212-7.066; p=0.017) and hypercarbia (4.673; 95% CI, 1.348-16.205; p=0.015) had a significantly high odds ratio for in-hospital mortalitycompared with normocarbia.Conclusion: In OHCA survivors treated with TH, dyscarbia(hypocarbia and hypercarbia) was frequent and dyscarbiashowed an association with in-hospital mortality.
Purpose: There is a lack of clinical evidence in terms of theassociation between carbon dioxide tension and outcomes incardiac arrest survivors treated with therapeutic hypothermia(TH). We investigated the association of time-weighted meancarbon dioxide tension (TWMCO2) and outcomes in out-ofhospitalcardiac arrest (OHCA) survivors treated with TH.Methods: This was a retrospective cohort study including177 OHCA survivors. The patients were divided into threegroups according to the values of TWMCO2 (normocarbia,35~45 mmHg; hypocarbia, <35 mmHg; hypercarbia, >45mmHg). The primary outcome was in-hospital mortality andthe secondary outcome was neurologic outcome at discharge.We assessed neurologic outcome at hospital dischargeusing the Cerebral Performance Categories (CPC).Neurologic outcome was dichotomized as either good neurologicoutcome (CPC1 and CPC2) or poor neurologic outcome(CPC 3 to 5). The odds ratio with 95% confidenceinterval (CI) was estimated.Results: The median value of PaCO2 was 38.2 (33.9-43.3)mmHg. Among a total of 1,239 PaCO2 values, normocarbia,hypocarbia, and hypercarbia were 618 (49.8%), 380(30.7%), and 241 (19.5%), respectively. Results of univariatelogistic regression analysis showed that hypocarbia hada significantly high odds ratio for in-hospital mortality (2.474(95% CI, 1.129-5.424), p=0.024) compared with normocarbia.Results of multivariate logistic regression analysisshowed that hypocarbia (2.926; 95% CI, 1.212-7.066; p=0.017) and hypercarbia (4.673; 95% CI, 1.348-16.205; p=0.015) had a significantly high odds ratio for in-hospital mortalitycompared with normocarbia.Conclusion: In OHCA survivors treated with TH, dyscarbia(hypocarbia and hypercarbia) was frequent and dyscarbiashowed an association with in-hospital mortality.
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