Abstract
Introduction: Profound anemia has been shown to have deleterious effects in critically ill patients (pts). Currently, no data exists regarding the effects of anemia on outcomes in pts post-cardiac arrest treated with therapeutic hypothermia (TH). We aim to evaluate whether a correlation between anemia and neurologic outcome exists in this high risk population. Methods: We performed a retrospective study of 260 consecutive comatose survivors of cardiac arrest treated with TH. Independent variables included hematocrit at time of admission, 24, 48 and 72 hrs post-admission as well as packed red blood cell transfusions. The outcome variable was Cerebral Performance Category (CPC) score at discharge. CPC scores 1-2 represented good neurologic outcomes while scores 3-5 represented poor outcomes. A Spearman correlation was computed between each of the above independent variables and discharge CPC, adjusting for the following risk factors: place of arrest, arrest rhythm, time to ROSC, witnessed arrest and presence of chronic kidney disease. Results: Of 260 pts, 101 (38.9%) had a good neurologic outcome (CPC≤2) at discharge. The mean hematocrit at admission for males and females was 40 ± 6.4 and 39.2 ±7 % respectively. The Spearman coefficient between hematocrit and CPC score at discharge was not statistically significant (Figure 1). Coefficient for hematocrit at admission and 72hrs with CPC score at discharge was 0.07 (p = 0.32) and 0.01 (p = 0.85) respectively. Coefficient for transfusions and CPC score was -0.11 (p =0.1). Conclusion: Our data suggest that neurological outcomes after cardiac arrest in pts treated with TH are unrelated to hematocrit levels or transfusions. Based on these findings, conservative transfusion strategies may be appropriate in this patient population.
Published Version
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