Abstract
Introduction: How mitochondrial damage from cardiac arrest (CA) and resuscitation affects oxygen metabolism, and whether changes in metabolism are associated with outcome, is not well understood. We previously reported an association between higher oxygen consumption (VO2) in the first 12 hours after return of spontaneous circulation (ROSC) and survival in 17 post-arrest (PA) patients. The present study was conducted to investigate the association of VO2, VCO2 and RQ with survival in a larger PA cohort. Methods: From adult patients enrolled in several CA trials at our center, we selected those receiving targeted temperature management with ≥60 minutes of post-ROSC metabolic data collected in the first 24 hours after ROSC, using a gas exchange monitor that measures continuous VO2, VCO2 and RQ.The area under the curve (AUC) for VO2, VCO2 and RQ was calculated using all available values in the first 12 and 24 hours after ROSC. For both time periods, logistic regression was used to describe the relationship between survival and each AUC. We adjusted for temperature, sedation, and vasopressor s. Hourly medians were plotted by survival. Results: Of 64 patients included, 32 (50%) survived. There was no significant association between survival and AUC-VO2 or AUC-VCO2 in the first 12 (n=43) or 24 (n=64) hours after ROSC. 21 (49%) had a median RQ <0.7 in the first 12 hours, and there was an association between survival and AUC-RQ in this time period (see table). Conclusion: There were no significant associations between VO2, VCO2 and survival in the first 12 and 24 hours after ROSC. RQ was abnormally low in many patients, and higher RQ in the first 12 hours after ROSC was associated with survival.
Published Version
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