저체온치료를 받은 병원전 심정지 환자에서 시간가중평균산소분압과 예후와의 관계 (The Relation between Time-weighted Mean Oxygen Tension and Outcome in Out-of-hospital Cardiac Arrest Survivors Treated with Therapeutic Hypothermia)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 25권 / 2호 / 174 ~ 182페이지
· 저자명 : 유승협, 이병국, 정경운, 정용훈, 이성민, 이동훈, 송경환, 허탁, 민용일

초록

Purpose: Studies to determine the relation between oxygentension and outcome in cardiac arrest survivors treated withtherapeutic hypothermia (TH) are lacking. We investigatedthe relation of time-weighted mean oxygen tension (TWMO2)and outcome in cardiac arrest survivors treated with TH.
Methods: This was a retrospective observational studyincluding 177 out-of-hospital cardiac arrest (OHCA) survivors.
The patients were divided into four categories according toquartile values of TWMO2. The primary outcome was neurologicoutcome at discharge and the secondary outcome wasall cause in-hospital mortality. We assessed neurologic outcomeusing the Cerebral Performance Categories (CPC) athospital discharge. Neurologic outcome was dichotomised aseither good neurologic outcome (CPC1 and CPC2) or poorneurologic outcome (CPC 3 to 5). The odds ratio with 95%confidence interval (CI) was estimated.
Results: The median value of PaO2 was 139(104.5-170.0)mmHg. Among a total of 1,239 PaO2 values, 22(1.8%) valueswere hypoxia (<60 mmHg) and 16(1.3%) values werehyperoxia (>300 mmHg). Results of univariate logisticregression analysis showed a significantly low odds ratio forpoor neurologic outcome [0.353(95% CI, 0.133-0.938) and0.321(95% CI, 0.121-0.850), respectively] and for in-hospitalmortality [0.338(95% CI, 0.132-0.870) and 0.387(95%CI, 0.154-0.975), respectively] for the third quartile and thefourth quartile. However, results of multivariate logisticregression analysis showed no significant relation betweenTWMO2 and outcomes.
Conclusion: In OHCA survivors treated with TH, timeweightedoxygen tension did not show an association withneurologic outcome and in-hospital mortality.

영어초록

Purpose: Studies to determine the relation between oxygentension and outcome in cardiac arrest survivors treated withtherapeutic hypothermia (TH) are lacking. We investigatedthe relation of time-weighted mean oxygen tension (TWMO2)and outcome in cardiac arrest survivors treated with TH.
Methods: This was a retrospective observational studyincluding 177 out-of-hospital cardiac arrest (OHCA) survivors.
The patients were divided into four categories according toquartile values of TWMO2. The primary outcome was neurologicoutcome at discharge and the secondary outcome wasall cause in-hospital mortality. We assessed neurologic outcomeusing the Cerebral Performance Categories (CPC) athospital discharge. Neurologic outcome was dichotomised aseither good neurologic outcome (CPC1 and CPC2) or poorneurologic outcome (CPC 3 to 5). The odds ratio with 95%confidence interval (CI) was estimated.
Results: The median value of PaO2 was 139(104.5-170.0)mmHg. Among a total of 1,239 PaO2 values, 22(1.8%) valueswere hypoxia (<60 mmHg) and 16(1.3%) values werehyperoxia (>300 mmHg). Results of univariate logisticregression analysis showed a significantly low odds ratio forpoor neurologic outcome [0.353(95% CI, 0.133-0.938) and0.321(95% CI, 0.121-0.850), respectively] and for in-hospitalmortality [0.338(95% CI, 0.132-0.870) and 0.387(95%CI, 0.154-0.975), respectively] for the third quartile and thefourth quartile. However, results of multivariate logisticregression analysis showed no significant relation betweenTWMO2 and outcomes.
Conclusion: In OHCA survivors treated with TH, timeweightedoxygen tension did not show an association withneurologic outcome and in-hospital mortality.

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