Cardiac gas on immediate postmortem computed tomography after cardiopulmonary resuscitation indicates the progression of anaerobic metabolism

Abstract

• Immediate postmortem CT after resuscitation shows cardiac gas (CG) in about half of the cases. • The presence of CG on immediate PMCT reflects anaerobic metabolism. • Certain items of coagulation and blood biochemistry reflect the severity of anaerobic metabolism. Cardiac gas (CG) on immediate postmortem computed tomography (PMCT) after cardiopulmonary resuscitation (CPR) reflects anaerobic metabolism during cardiopulmonary arrest (CPA) with CPR. Our study investigated the correlation between coagulation, blood count, biochemistry , and CG on immediate PMCT, and attempted to establish a comprehensive interpretation of the laboratory data from blood tests of patients during CPA with CPR. We enrolled 241 patients with nontraumatic CPA who were transferred to our hospital and could not be resuscitated. Patients underwent arterial blood gas analysis; coagulation, blood count, and blood biochemistry measurements; and immediate PMCT after failed resuscitation; they were assigned to a CG-negative or CG-positive group based on the PMCT findings. Among the 241 patients, 124 (51.5%) demonstrated CG on immediate PMCT. Significant differences between the CG-negative and CG-positive groups were found for activated partial thromboplastin time, potassium, chloride, total protein, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, ammonia, and total cholesterol. Certain items of coagulation and blood biochemistry more sensitively reflect the severity of anaerobic metabolism