Abstract 174: Usefulness Of Cerebrospinalfluid Partial Pressure Of Carbone Dioxide As A Predictor Of Poor Neurological Outcomes In Cardiac Arrest Patients Who Underwent Target Temperature Management.

Abstract

Aim: We aimed to predict the six-month neurological outcomes of out-of-hospital cardiac arrest(OHCA) patients who underwent target temperature management(TTM) using cerebrospinal fluid(CSF) partial pressure of carbon dioxide(PCO 2 ). Hypothesis: We hypothesized that CSF PCO 2 would decrease after cardiac arrest. The buffer system and viscosity of the CSF change when the blood-brain barrier ​​and blood cerebrospinal fluid barrier are disrupted and ions and proteins are released from damaged neurons and cells into the CSF. Methods: We performed gas analysis of arterial blood and CSF samples to assess the PCO 2 of OHCA patients who underwent TTM from November 2018 to August 2021. The PCO 2 was assessed immediately (Day 0) and 24h (Day 1), 48h (Day 2), and 72h (Day 3) after the return of spontaneous circulation (ROSC). The primary outcome was Cerebral Performance Category 3-5 six months after cardiac arrest. Results: Of 67 (males, 49; 73.1%) enrolled patients, thirty-nine(58.2%) had a poor neurologic outcome. The poor neurologic outcome group had significantly lower CSF PCO 2 each time after ROSC (Figure 1). The area under the curve of the CSF PCO 2 on Day 1 was 0.823 (95% confidence interval [CI], 0.692-0.915), with a cutoff value of 30 mmHg. Conclusion: The CSF PCO 2 was lower at each time point after the ROSC for the patients with poor neurologic outcomes, and it maybe a useful predictor of neurologic outcomes of OHCA survivors treated with TTM.