Abstract
Objectives
The association between intra-arrest and post-arrest hyperoxia and mortality in adults
with cardiac arrest (CA) is widely debated. We therefore conducted a systematic review
and meta-analysis to investigate the association between intra-arrest and post-arrest
hyperoxia and mortality in adults with CA.
Methods
We systematically searched MEDLINE and Cochrane databases to identify observational
studies from January 2008 to December 2017 investigating the relationship between
hyperoxia (either intra-arrest or post-arrest) and mortality in adults with CA.
Results
We included 16 observational studies with a total of 40,573 adult patients. Six studies
included patients only with out-of-hospital CA (OHCA), 2 studies included patients
only with in-hospital CA (IHCA), and 8 studies included patients with both OHCA and
IHCA. Two studies assessed intra-arrest hyperoxia while 14 studies examined post-arrest
hyperoxia. Of the 10 studies included for quantitative analysis, intra-arrest hyperoxia
was associated with a significantly lower mortality rate [odds ratio (OR) 0.25, 95%
confidence interval (CI) 0.12–0.53, p < 0.001] while post-arrest hyperoxia was associated
with higher mortality (OR 1.34, 95%CI 1.08–1.67, p = 0.008).
Conclusions
In adults with CA, intra-arrest hyperoxia is associated with lower mortality while
post-arrest hyperoxia is associated with higher mortality.
Keywords
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References
- Executive summary: heart disease and stroke statistics--2016 update: a report from the American Heart Association.Circulation. 2016; 133: 447-454
- Heart disease and stroke statistics-2017 update: a report from the American Heart Association.Circulation. 2017; 135: e146-e603
- American Heart Association focused update on adult basic life support and cardiopulmonary resuscitation quality: an update to the American Heart Association guidelines for cardio pulmonary resuscitation and emergency cardiovascular care.Circulation. 2017; 2017
- Part 8: post-cardiac arrest care: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care.Circulation. 2015; 132: S465-82
- The effect of hyperoxia on survival following adult cardiac arrest: a systematic review and meta-analysis of observational studies.Resuscitation. 2014; 85: 1142-1148
- Hyperoxia is associated with increased mortality in patients treated with mild therapeutic hypothermia after sudden cardiac arrest.Crit Care Med. 2012; 40: 3135-3139
- Prevalence and factors correlating with hyperoxia exposure following cardiac arrest–an observational single centre study.Scand J Trauma Resuscitat Emerg Med. 2013; 21: 35
- Association of arterial oxygen tension during in-hospital cardiac arrest with return of spontaneous circulation and survival.J Intensive Care Med. 2016; (in press)
- Increasing arterial oxygen partial pressure during cardiopulmonary resuscitation is associated with improved rates of hospital admission.Resuscitation. 2013; 84: 770-775
- Post-resuscitation arterial oxygen and carbon dioxide and outcomes after out-of-hospital cardiac arrest.Resuscitation. 2017; 120: 113-118
- The association between arterial oxygen tension and neurological outcome after cardiac arrest.Ther Hypother Temp Manage. 2017; 7: 36-41
- The value of arterial blood gas parameters for prediction of mortality in survivors of out-of-hospital cardiac arrest.J Emerg Trauma Shock. 2017; 10: 134-139
- Hyperoxia early after hospital admission in comatose patients with non-traumatic out-of-hospital cardiac arrest.Med Sci Monit. 2016; 22: 3296-3300
- The association between hyperoxia and patient outcomes after cardiac arrest: analysis of a high-resolution database.Intensive Care Med. 2015; 41: 49-57
- Associations of arterial carbon dioxide and arterial oxygen concentrations with hospital mortality after resuscitation from cardiac arrest.Crit Care (Lond, Engl). 2015; 19: 348
- Early hyperoxemia may not increase mortality after cardiac arrest: a pilot study.Clin Exp Emerg Med. 2014; 1: 28-34
- Association between mean arterial blood gas tension and outcome in cardiac arrest patients treated with therapeutic hypothermia.Am J Emerg Med. 2014; 32: 55-60
- Hyperoxia in the intensive care unit and outcome after out-of-hospital ventricular fibrillation cardiac arrest.Crit Care Resusc. 2013; 15: 186-190
- Relationship between supranormal oxygen tension and outcome after resuscitation from cardiac arrest.Circulation. 2011; 123: 2717-2722
- Arterial hyperoxia and in-hospital mortality after resuscitation from cardiac arrest.Crit Care (Lond, Engl). 2011; 15: R90
- Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality.JAMA. 2010; 303: 2165-2171
- Arterial blood gas tensions after resuscitation from out-of-hospital cardiac arrest: associations with long-term neurologic outcome.Crit Care Med. 2014; 42: 1463-1470
- Association between early arterial blood gas tensions and neurological outcome in adult patients following in-hospital cardiac arrest.Resuscitation. 2015; 89: 1-7
- The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.Ann Intern Med. 2009; 151: W65-94
- ROBIS: a new tool to assess risk of bias in systematic reviews was developed.J Clin Epidemiol. 2016; 69: 225-234
- Relationship between the hemoglobin level at hospital arrival and post-cardiac arrest neurologic outcome.Am J Emerg Med. 2012; 30: 770-774
- Estimated cerebral oxyhemoglobin as a useful indicator of neuroprotection in patients with post-cardiac arrest syndrome: a prospective, multicenter observational study.Crit Care (Lond, Engl). 2014; 18: 500
- Oxygen requirement during cardiopulmonary resuscitation (CPR) to effect return of spontaneous circulation.Resuscitation. 2009; 80: 951-955
- Comparison of 30 and the 100% inspired oxygen concentrations during early post-resuscitation period: a randomised controlled pilot study.Resuscitation. 2006; 69: 199-206
Article info
Publication history
Published online: April 10, 2018
Accepted:
April 9,
2018
Received in revised form:
March 14,
2018
Received:
January 21,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
