Cerebral oxygenation in mechanically ventilated early cardiac arrest survivors: The impact of hypercapnia

Eastwood, Glenn M., Tanaka, Aiko and Bellomo, Rinaldo 2016, Cerebral oxygenation in mechanically ventilated early cardiac arrest survivors: The impact of hypercapnia, Resuscitation, vol. 102, pp. 11-16, doi: 10.1016/j.resuscitation.2016.02.009.

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Title Cerebral oxygenation in mechanically ventilated early cardiac arrest survivors: The impact of hypercapnia
Author(s) Eastwood, Glenn M.
Tanaka, Aiko
Bellomo, Rinaldo
Journal name Resuscitation
Volume number 102
Start page 11
End page 16
Total pages 6
Publisher Elsevier Ireland
Place of publication Shannon, Ireland
Publication date 2016-05
ISSN 0300-9572
Keyword(s) cardiac arrest
cerebral oxygenation
mechanical ventilation
Summary BACKGROUND : Optimal cerebral oxygenation is considered fundamental to cerebral protection in cardiac arrest (CA) patients. Hypercapnia increases cerebral blood flow and may also improve cerebral oxygenation. It is uncertain, however, whether this effect occurs in mechanically ventilated early survivors of CA. METHODS: We enrolled mechanically ventilated resuscitated patients within 36 h of their cardiac arrest. We performed a prospective double cross-over physiological study comparing the impact of normocapnia (PaCO2 35-45 mmHg) vs. mild hypercapnia (PaCO2 45-55 mmHg) on regional cerebral tissue oxygen saturation (SctO2) assessed by near infrared spectroscopy (NIRS).RESULTS: We studied seven adult CA patients with a median time to return of spontaneous circulation of 28 min at a median of 26 h and 30 min after CA. During normocapnia (median EtCO2 of 32 mmHg [30-41 mmHg] and PaCO2 of 37 mmHg [32-45 mmHg]) the median NIRS-derived left frontal SctO2 was 61% [52-65%] and the right frontal SctO2 was 61% [54-68%]. However, during mild hypercapnia (median EtCO2 of 49 mmHg [40-57 mmHg] and PaCO2 of 52 mmHg [43-55 mmHg) the median left frontal SctO2 increased to 69% [59-78%] and the right frontal SctO2 increased to 73% [61-76%])(p = 0.001, for all comparisons). CONCLUSION: During the early post-resuscitation period, in mechanically ventilated CA patients, mild hypercapnia increases cerebral oxygenation as assessed by NIRS. Further investigations of the effect of prolonged mild hypercapnia on cerebral oxygenation and patient outcomes appear justified.
Language eng
DOI 10.1016/j.resuscitation.2016.02.009
Field of Research 110399 Clinical Sciences not elsewhere classified
1103 Clinical Sciences
1117 Public Health And Health Services
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Elsevier Ireland
Persistent URL http://hdl.handle.net/10536/DRO/DU:30085601

Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
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