Featured Research

from universities, journals, and other organizations

Excess oxygen in blood after cardiac resuscitation may increase risk of in-hospital death

Date:
June 3, 2010
Source:
JAMA and Archives Journals
Summary:
Patients who have excessive oxygen levels in arterial blood (hyperoxia) following resuscitation from cardiac arrest have a higher rate of death in the hospital than similar patients without arterial hyperoxia, according to a new study.

Patients who have excessive oxygen levels in arterial blood (hyperoxia) following resuscitation from cardiac arrest have a higher rate of death in the hospital than similar patients without arterial hyperoxia, according to a study in the June 2 issue of JAMA.

The most common lethal conse­quence of cardiovascular dis­ease is sudden cardiac arrest. Even if return of spontaneous circulation (ROSC) from cardiac arrest is achieved, approximately 60 percent of patients will not survive to hospital discharge, according to background information in the article. "In the search for modifiable post-ROSC factors, the role of supplemen­tal oxygen, which is often administered in high concentrations to patients after cardiac arrest has come into controversy," the authors write. "Laboratory investigations suggest that exposure to hyperoxia after resuscita­tion from cardiac arrest may worsen anoxic brain injury; however, clinical data are lacking."

J. Hope Kilgannon, M.D., of Cooper University Hospi­tal, Camden, N.J., and colleagues conducted a study to determine whether hyper­oxia after ROSC from cardiac arrest was associated with poor clinical out­come. The study included information from a critical care database of intensive care units (ICUs) at 120 U.S. hospitals, from between 2001 and 2005. Patient inclusion criteria included older than 17 years of age, nontraumatic car­diac arrest, cardiopulmonary resuscitation within 24 hours prior to ICU arrival, and ar­terial blood gas analysis performed within 24 hours following ICU arrival. Patients were divided into 3 groups based on a measurement of oxygen in arterial blood.

Of 6,326 patients, 1,156 had hyperoxia (18 percent), 3,999 had hypoxia (63 percent; deficiency of oxygen in the blood), and 1,171 had normoxia (19 percent; normal level of oxygen in the blood). The researchers found that mortality was highest in the hyperoxia group (63 percent) com­pared with the hypoxia group (57 percent) and the normoxia group (45 percent). The hyperoxia group had significantly higher in-hospital mor­tality compared with the normoxia group (proportion difference, 18 percent). Mortality also was significantly higher in the hyper­oxia group compared with the hypoxia group (proportion difference, 6 percent). "Exposure to hyperoxia was found to be a signifi­cant predictor of in-hospital death," the authors write.

The researchers also found that among hospital survivors, hyperoxia was associated with a lower likelihood of independent functional status at hos­pital discharge compared with nor­moxia.

"While we acknowledge that association does not necessarily imply causation, these data support the hypothesis that high oxygen delivery in the postcardiac arrest setting may have adverse effects," they write.

Editorial: Titrating Oxygen During and After Cardiopulmonary Resuscitation

Patrick M. Kochanek, M.D., and Hulya Bayir, M.D., of the University of Pittsburgh School of Medi­cine, comment on the findings of this study.

"Experimental evidence suggests that the risk of oxida­tive injury may be greatest early in resuscitation, possibly related to the initial burst of reperfusion. Accordingly, unconventional resuscitation strategies that were considered but heretofore unproven (such as intermittent, controlled, or even delayed reperfusion) are being explored in the labo­ratory with promising results in some cases. Such an ap­proach might be particularly important in the setting of prolonged cardiac arrest. With the upcoming 50th anniversary of the birth of cardiopulmonary resuscitation, the work of Kilgannon et al provides an impetus for better defining the use of oxygen in all settings of cerebral resuscitation, in further exploring these revolutionary approaches to resus­citation, and in examining other strategies such as the com­bination of 100 percent oxygen with antioxidant therapy …"


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Kilgannon et al. Association Between Arterial Hyperoxia Following Resuscitation From Cardiac Arrest and In-Hospital Mortality. JAMA The Journal of the American Medical Association, 2010; 303 (21): 2165 DOI: 10.1001/jama.2010.707

Cite This Page:

JAMA and Archives Journals. "Excess oxygen in blood after cardiac resuscitation may increase risk of in-hospital death." ScienceDaily. ScienceDaily, 3 June 2010. <www.sciencedaily.com/releases/2010/06/100601162245.htm>.
JAMA and Archives Journals. (2010, June 3). Excess oxygen in blood after cardiac resuscitation may increase risk of in-hospital death. ScienceDaily. Retrieved September 19, 2014 from www.sciencedaily.com/releases/2010/06/100601162245.htm
JAMA and Archives Journals. "Excess oxygen in blood after cardiac resuscitation may increase risk of in-hospital death." ScienceDaily. www.sciencedaily.com/releases/2010/06/100601162245.htm (accessed September 19, 2014).

Share This



More Health & Medicine News

Friday, September 19, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Could Grief Affect The Immune Systems Of Senior Citizens?

Could Grief Affect The Immune Systems Of Senior Citizens?

Newsy (Sep. 19, 2014) — The study found elderly people are much more likely to become susceptible to infection than younger adults going though a similar situation. Video provided by Newsy
Powered by NewsLook.com
Jury Delivers Verdict in Salmonella Trial

Jury Delivers Verdict in Salmonella Trial

AP (Sep. 19, 2014) — A federal jury has convicted three people in connection with an outbreak of salmonella poisoning five years ago that sickened hundreds of people and was linked to a number of deaths. (Sept. 19) Video provided by AP
Powered by NewsLook.com
How The 'Angelina Jolie Effect' Increased Cancer Screenings

How The 'Angelina Jolie Effect' Increased Cancer Screenings

Newsy (Sep. 19, 2014) — Angelina's Jolie's decision to undergo a preventative mastectomy in 2013 inspired many women to seek early screenings for the disease. Video provided by Newsy
Powered by NewsLook.com
The Cost of Ebola

The Cost of Ebola

Reuters - Business Video Online (Sep. 18, 2014) — As Sierra Leone prepares for a three-day "lockdown" in its latest bid to stem the spread of Ebola, Ciara Lee looks at the financial implications of fighting the largest ever outbreak of the disease. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins