首页|A novel predictor of unsustained return of spontaneous circulation in cardiac arrest patients through a combination of capnography and pulse oximetry:a multicenter observational study

A novel predictor of unsustained return of spontaneous circulation in cardiac arrest patients through a combination of capnography and pulse oximetry:a multicenter observational study

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  • 国家科技期刊平台
  • NETL
  • NSTL
  • 万方数据
BACKGROUND:Unsustained return of spontaneous circulation(ROSC)is a critical barrier to survival in cardiac arrest patients.This study examined whether end-tidal carbon dioxide(ETCO2)and pulse oximetry photoplethysmogram(POP)parameters can be used to identify unsustained ROSC.METHODS:We conducted a multicenter observational prospective cohort study of consecutive patients with cardiac arrest from 2013 to 2014.Patients'general information,ETCO2,and POP parameters were collected and statistically analyzed.RESULTS:The included 105 ROSC episodes(from 80 cardiac arrest patients)comprised 51 sustained ROSC episodes and 54 unsustained ROSC episodes.The 24-hour survival rate was significantly higher in the sustained ROSC group than in the unsustained ROSC group(29.2%vs.9.4%,P＜0.05).The logistic regression analysis showed that the difference between after and before ROSC in ETCO2(ΔETCO2)and the difference between after and before ROCS in area under the curve of POP(ΔAUCp)were independently associated with sustained ROSC(odds ratio[OR]=0.931,95%confidence interval[95%CI]0.881-0.984,P=0.011 and OR=0.998,95%CI 0.997-0.999,P＜0.001).The area under the receiver operating characteristic curve of ΔETCO2,ΔAUCp,and the combination of both to predict unsustained ROSC were 0.752(95%CI 0.660-0.844),0.883(95%CI 0.818-0.948),and 0.902(95%CI 0.842-0.962),respectively.CONCLUSION:Patients with unsustained ROSC have a poor prognosis.The combination of ΔETCO2 and ΔAUCp showed significant predictive value for unsustained ROSC.

Return of spontaneous circulationPulse oximetry photoplethysmogramEnd-tidal carbon dioxideCardiac arrestCardiopulmonary resuscitation

Jing Yang、Hanqi Tang、Shihuan Shao、Feng Xu、Yangyang Fu、Shengyong Xu、Chen Li、Yan Li、Yang Liu、Joseph Harold Walline、Huadong Zhu、Yuguo Chen、Xuezhong Yu、Jun Xu

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Emergency Department,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100730,China

Emergency Department,Peking University People's Hospital,Beijing 100044,China

Department of Emergency and Chest Pain Center

Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine

Key Laboratory of Emergency and Critical Care Medicine of Shandong Province,Qilu Hospital of Shandong University,Jinan 250012,China

Emergency Department,Beijing Jishuitan Hospital,Beijing 100035,China

Emergency Department,Tianjin Medical University General Hospital,Tianjin 300052,China

Department of Emergency Medicine,Penn State Health Milton S.Hershey Medical Center and Penn State College of Medicine,Hershey 17033,USA

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National Natural Science Foundation of China General ProgramMathematics Tianyuan FundCentral High-level Hospital Clinical Research Project

82172179121266042022-PUMCH-B-110

2024

10.5847/wjem.j.1920-8642.2023.186

世界急诊医学杂志(英文)
浙江大学,浙江大学医学院附属第二医院

世界急诊医学杂志(英文)

ISSN：1920-8642
年,卷(期)：2024.15(1)
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