Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan.
Journal of Intensive Care · 2020-01-01 · Observational study
Abstract
BACKGROUND: We aimed to identify the association of pH value in blood gas assessment with neurological outcome among out-of-hospital cardiac arrest (OHCA) patients treated by extracorporeal cardiopulmonary resuscitation (ECPR). METHODS: We retrospectively analyzed the database of a multicenter prospective observational study on OHCA patients in Osaka prefecture, Japan (CRITICAL study), from July 1, 2012 to December 31, 2016. We included adult OHCA patients treated by ECPR. Patients with OHCA from external causes such as trauma were excluded. We conducted logistic regression analysis to identify the odds ratio (OR) and 95% confidence interval (CI) of the pH value for 1 month favorable neurological outcome adjusted for potential confounders including sex, age, witnessed by bystander, CPR by bystander, pre-hospital initial cardiac rhythm, and cardiac rhythm on hospital arrival. RESULTS: Among the 9822 patients in the database, 260 patients were finally included in the analysis. The three groups were Tertile 1: pH ≥ 7.030, Tertile 2: pH 6.875-7.029, and Tertile 3: pH < 6.875. The adjusted OR of Tertiles 2 and 3 compared with Tertile 1 for 1 month favorable neurological outcome were 0.26 (95% CI 0.10-0.63) and 0.24 (95% CI 0.09-0.61), respectively. CONCLUSIONS: This multi-institutional observational study showed that low pH value (< 7.03) before the implementation of ECPR was associated with 1 month unfavorable neurological outcome among OHCA patients treated with ECPR. It may be helpful to consider the candidate for ECPR.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Mortality & survival · Quality of life & function · Point-of-care tests
Related articles
- Prehospital prediction of survival after out-of-hospital cardiac arrest using point-of-care testing and vital signs: a prospective, multinational study. (Sci Rep, 2026)
- Elective Initial Blood Testing for the Neurological Outcomes of Pediatric Out-of-Hospital Cardiac Arrests. (Pediatr Int, 2026)
- Utility of Glucose Testing and Treatment of Hypoglycemia in Patients with Out-of-Hospital Cardiac Arrest. (Prehosp Emerg Care, 2022)
- Prognostic value of venous blood analysis at the start of CPR in non-traumatic out-of-hospital cardiac arrest: association with ROSC and the neurological outcome. (Crit Care, 2020)
- Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients. (Turk J Med Sci, 2019)
- Impact of Cardiac Rhythm Dynamics during Cardiopulmonary Resuscitation on Clinical Outcomes in Patients Treated with Extracorporeal Cardiopulmonary Resuscitation (ECPR): A Systematic Review and Meta-analysis. (Resuscitation, 2026)