Advertisement

Hyperoxia following cardiac arrest: How much is too much?

  • Keith Couper
    Correspondence
    Corresponding author at: Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, MIDRU, Birmingham Heartlands Hospital, Birmingham B9 5SS, United Kingdom.
    Affiliations
    Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham, UK

    Warwick Medical School, University of Warwick, Coventry, UK
    Search for articles by this author
  • Joyce Yeung
    Affiliations
    Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham, UK

    School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
    Search for articles by this author
      Despite advances in resuscitation science, most cardiac arrest patients who obtain a return of spontaneous circulation (ROSC) do not survive to leave hospital.
      • Nolan J.P.
      • Soar J.
      • Smith G.B.
      • et al.
      Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit.
      • Perkins G.D.
      • Cooke M.W.
      Variability in cardiac arrest survival: the NHS Ambulance Service Quality Indicators.
      A common cause of mortality after ROSC is post-cardiac arrest brain injury.
      • Laver S.
      • Farrow C.
      • Turner D.
      • Nolan J.
      Mode of death after admission to an intensive care unit following cardiac arrest.
      Forming part of the post-cardiac arrest syndrome, this pathophysiological process stems from the brain's unique susceptibility to both ischaemia and subsequent reperfusion.
      • Nolan J.P.
      • Neumar R.W.
      • Adrie C.
      • et al.
      Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke.
      Whilst the importance of post-resuscitation care has been recognised for many years, it is now ingrained in resuscitation practice through its inclusion as a link in the chain of survival.
      • Tagami T.
      • Hirata K.
      • Takeshige T.
      • et al.
      Implementation of the fifth link of the chain of survival concept for out-of-hospital cardiac arrest.
      • Negovsky V.A.
      The second step in resuscitation—the treatment of the ‘post-resuscitation’ disease.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Resuscitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Nolan J.P.
        • Soar J.
        • Smith G.B.
        • et al.
        Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit.
        Resuscitation. 2014; 85: 987-992
        • Perkins G.D.
        • Cooke M.W.
        Variability in cardiac arrest survival: the NHS Ambulance Service Quality Indicators.
        Emerg Med J. 2012; 29: 3-5
        • Laver S.
        • Farrow C.
        • Turner D.
        • Nolan J.
        Mode of death after admission to an intensive care unit following cardiac arrest.
        Intensive Care Med. 2004; 30: 2126-2128
        • Nolan J.P.
        • Neumar R.W.
        • Adrie C.
        • et al.
        Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke.
        Resuscitation. 2008; 79: 350-379
        • Tagami T.
        • Hirata K.
        • Takeshige T.
        • et al.
        Implementation of the fifth link of the chain of survival concept for out-of-hospital cardiac arrest.
        Circulation. 2012; 126: 589-597
        • Negovsky V.A.
        The second step in resuscitation—the treatment of the ‘post-resuscitation’ disease.
        Resuscitation. 1972; 1: 1-7
        • Yeung J.
        • Couper K.
        • Giles S.
        • Perkins G.
        Advances in post resuscitation care.
        J Intensive Care Soc. 2010; 11: 112-117
        • Sunde K.P.
        • Pytte M.
        • Jacobsen D.
        • et al.
        Implementation of a standardised treatment protocol for post resuscitation care after out-of-hospital cardiac arrest.
        Resuscitation. 2007; 73: 29-39
        • Wang C.-H.
        • Chang W.-T.
        • Huang C.-H.
        • et al.
        The effect of hyperoxia on survival following adult cardiac arrest: a systematic review and meta-analysis of observational studies.
        Resuscitation. 2014; 85: 1142-1148
        • Pilcher J.
        • Weatherall M.
        • Shirtcliffe P.
        • Bellomo R.
        • Young P.
        • Beasley R.
        The effect of hyperoxia following cardiac arrest – a systematic review and meta-analysis of animal trials.
        Resuscitation. 2012; 83: 417-422
        • Kuisma M.
        • Boyd J.
        • Voipio V.
        • Alaspää A.
        • Roine R.O.
        • Rosenberg P.
        Comparison of 30 and the 100% inspired oxygen concentrations during early post-resuscitation period: a randomised controlled pilot study.
        Resuscitation. 2006; 69: 199-206
        • Kilgannon J.
        • Jones A.E.
        • Shapiro N.I.
        • et al.
        Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality.
        J Am Med Assoc. 2010; 303: 2165-2171
        • Spindelboeck W.
        • Schindler O.
        • Moser A.
        • et al.
        Increasing arterial oxygen partial pressure during cardiopulmonary resuscitation is associated with improved rates of hospital admission.
        Resuscitation. 2013; 84: 770-775
        • Young P.
        • Pilcher J.
        • Patel M.
        • et al.
        Delivery of titrated oxygen via a self-inflating resuscitation bag.
        Resuscitation. 2013; 84: 391-394
        • de Jonge E.
        • Peelen L.
        • Keijzers P.
        • et al.
        Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients.
        Crit Care. 2008; 12: R156
        • Neumar R.W.
        Optimal oxygenation during and after cardiopulmonary resuscitation.
        Curr Opin Crit Care. 2011; 17: 236-240
        • Deakin C.D.
        • Nolan J.P.
        • Soar J.
        • et al.
        European resuscitation council guidelines for resuscitation 2010 section 4. Adult advanced life support.
        Resuscitation. 2010; 81: 1305-1352
        • O’Driscoll B.R.
        • Howard L.S.
        • Davison A.G.
        BTS guideline for emergency oxygen use in adult patients.
        Thorax. 2008; 63: vi1-vi68