Diastolic blood pressures and end tidal carbon dioxides during cardiopulmonary resuscitations and their association with outcomes in adult out-of-hospital cardiac arrest patients: a preplanned secondary analysis of the Augmented Medication CardioPulmonary Resuscitation (AMCPR) trial.

IF 6.5 1区医学 Q1 CRITICAL CARE MEDICINE

Resuscitation Pub Date : 2025-02-12 DOI:10.1016/j.resuscitation.2025.110537

June-Sung Kim, Youn-Jung Kim, Seok In Hong, Sang-Min Kim, Bora Chae, Seung Mok Ryoo, Won Young Kim

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引用次数: 0

Abstract

Background: The optimal targets for diastolic blood pressure (DBP) and end-tidal carbon dioxide (ETCO2) during cardiopulmonary resuscitation (CPR) and their association with outcomes remain unclear. This study aimed to evaluate the association between DBP and ETCO2 and the return of spontaneous circulation (ROSC) during CPR.

Methods: This study was a preplanned sub-analysis of the Augmented Medication CardioPulmonary Resuscitation (AMCPR) trial. We extracted initial (within 5 minutes), follow-up (around 10 minutes), and delta (follow-up minus initial) values of DBP and ETCO2 from the registry. The primary outcome was sustained ROSC (≥20 minutes).

Results: The study included 264 patients, mostly male (69.3%) and with a median age of 74 years old. Of these patients, 101 (38.3%) achieved sustained ROSC. Patients with sustained ROSC had statistically higher initial, follow-up, and delta values of DBP compared to those without ROSC. However, the levels of ETCO2 were similar between the two groups, except for follow-up values. Follow-up DBP above 26.5 and delta DBP above 6.5 were independently associated with sustained ROSC (adjusted odds ratio, aOR = 10.03, 95% confidence interval, CI = 3.64 - 27.66, p < 0.01, and aOR = 4.83, 95% CI = 1.90 - 12.26, p < 0.01).

Conclusion: Monitoring DBP during resuscitation in patients with cardiac arrest may provide additional information about successful initial resuscitation. Improving certain levels of DBP may influence outcomes.

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心肺复苏过程中的舒张压和潮气末二氧化碳及其与院外心脏骤停成人患者预后的关系：增强药物心肺复苏（AMCPR）试验的预案二次分析。

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来源期刊

Resuscitation 医学-急救医学

CiteScore

12.00

自引率

18.50%

发文量

556

审稿时长

21 days

期刊介绍： Resuscitation is a monthly international and interdisciplinary medical journal. The papers published deal with the aetiology, pathophysiology and prevention of cardiac arrest, resuscitation training, clinical resuscitation, and experimental resuscitation research, although papers relating to animal studies will be published only if they are of exceptional interest and related directly to clinical cardiopulmonary resuscitation. Papers relating to trauma are published occasionally but the majority of these concern traumatic cardiac arrest.