Current post-arrest guideilnes recommend titrating supplemental O2 to avoid hypoxia and limit exposure to hyperoxia.
Importantly, these recommendations are based primarily on retrospective studies that have used ABG values within the first 24 hours following ROSC.
The latest study to evaluate the impact of hyperoxia following cardiac arrest was just published in Circulation.
This study is a prospective, cohort study that evaluated the association between early hyperoxia and poor neurologic outcome in adults following cardiac arrest. (ABGs were obtained at 1 hour and 6 hours following ROSC)
Of 280 patients, 38% were exposed to early hyperoxia (defined as a PaO2 > 300 mm Hg)
Take Home Points
Early hyperoxia was found to be an independent predictor of poor neurologic outcome at hospital discharge.
One hour longer duration of hyperoxia was associated with a 3% increase in the risk of poor neurologic outcome
SaO2 could not reliably exclude the presence of hyperoxia.
References
Roberts BW, et al. Association between early hyperoxia exposure after resuscitation from cardiac arrest and neurological disability: a prospective multi-center protocol-directed cohort study. Circulation 2018; epub ahead of print.
