Faculty Collaboration Database

The impact of severe acidemia on neurologic outcome of cardiac arrest survivors undergoing therapeutic hypothermia. Resuscitation 2013 Dec;84(12):1723-7

Date

08/07/2013

Pubmed ID

23916553

DOI

10.1016/j.resuscitation.2013.07.006

Scopus ID

2-s2.0-84887226426 (requires institutional sign-in at Scopus site)   34 Citations

Abstract

INTRODUCTION: Therapeutic Hypothermia (TH) has become a standard of care in improving neurological outcomes in cardiac arrest (CA) survivors. Previous studies have defined severe acidemia as plasma pH<7.20. We investigated the influence of severe acidemia at the time of initiation of TH on neurological outcome in CA survivors.

METHODS: A retrospective analysis was performed on 196 consecutive CA survivors (out-of-hospital CA and in-hospital CA) who underwent TH with endovascular cooling between January 2007 and October 2012. Arterial blood gas drawn prior to initiation of TH was utilized to measure pH in all patients. Shockable and non-shockable CA patients were divided into two sub-groups based on pH (pH<7.2 and pH≥7.2). The primary end-point was measured using the Pittsburgh Cerebral Performance Category (CPC) scale prior to discharge from the hospital: good (CPC 1 and 2) and poor (CPC 3 to 5) neurologic outcome.

RESULTS: Sixty-two percent of shockable CA patients with pH≥7.20 had good neurological outcome as compared to 34% patients with pH<7.20. Shockable CA patients with pH≥7.20 were 3.3 times more likely to have better neurological outcome when compared to those with pH <7.20 [p=0.013, OR 3.3, 95% CI (1.28-8.45)]. In comparison, non-shockable CA patients with p≥7.20 did not have a significantly different neurological outcome as compared to those with pH<7.20 [p=0.97, OR 1.02, 95% CI (0.31-3.3)].

CONCLUSION: Presence of severe acidemia at initiation of TH in shockable CA survivors is significantly associated with poor neurological outcomes. This effect was not observed in the non-shockable CA survivors.

Author List

Ganga HV, Kallur KR, Patel NB, Sawyer KN, Gowd PB, Nair SU, Puppala VK, Manandhi AR, Gupta AV, Lundbye JB

MESH terms used to index this publication - Major topics in bold

Acidosis
Aged
Female
Heart Arrest
Humans
Hydrogen-Ion Concentration
Hypothermia, Induced
Male
Middle Aged
Retrospective Studies