Blood gas phenotyping and tracheal intubation timing in adult in-hospital cardiac arrest: a retrospective cohort study

Abstract To investigate whether the optimal time to tracheal intubation (TTI) during cardiopulmonary resuscitation would differ by different blood gas phenotypes. Adult patients experiencing in-hospital cardiac arrest (IHCA) from 2006 to 2015 were retrospectively screened. Early intra-arrest blood g...

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Autores principales:	Chih-Hung Wang, Meng-Che Wu, Cheng-Yi Wu, Chien-Hua Huang, Min-Shan Tsai, Tsung-Chien Lu, Eric Chou, Yen-Wen Wu, Wei-Tien Chang, Wen-Jone Chen
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c5ebd3e08ff0495c98855a84159b6480
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spelling	oai:doaj.org-article:c5ebd3e08ff0495c98855a84159b64802021-12-02T14:59:06ZBlood gas phenotyping and tracheal intubation timing in adult in-hospital cardiac arrest: a retrospective cohort study10.1038/s41598-021-89920-y2045-2322https://doaj.org/article/c5ebd3e08ff0495c98855a84159b64802021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89920-yhttps://doaj.org/toc/2045-2322Abstract To investigate whether the optimal time to tracheal intubation (TTI) during cardiopulmonary resuscitation would differ by different blood gas phenotypes. Adult patients experiencing in-hospital cardiac arrest (IHCA) from 2006 to 2015 were retrospectively screened. Early intra-arrest blood gas analysis, performed within 10 min of resuscitation, was used to define different phenotypes. In total, 567 patients were included. Non-severe acidosis (pH≧7.15) was associated with favourable neurological outcome (odds ratio [OR]: 4.60, 95% confidence interval [CI] 1.63–12.95; p value = 0.004) and survival (OR: 3.25, 95% CI 1.72–6.15; p value < 0.001) in the multivariable logistic regression analyses. In the interaction analysis, normal blood gas phenotype (pH: 7.35–7.45, PCO2: 35–45 mm Hg, HCO3 − level: 22–26 mmol/L) × TTI ≦ 6.3 min (OR: 20.40, 95% CI 2.53–164.75; p value = 0.005) and non-severe acidosis × TTI ≦ 6.3 min (OR: 3.35, 95% CI 1.00–11.23; p value = 0.05) were associated with neurological recovery while metabolic acidosis × TTI ≦ 5.7 min (OR: 3.63, 95% CI 1.36–9.67; p value = 0.01) and hypercapnic acidosis × TTI ≦ 10.4 min (OR: 2.27, 95% CI 1.20–4.28; p value = 0.01) were associated with survival. Intra-arrest blood gas analysis may help guide TTI during for patients with IHCA.Chih-Hung WangMeng-Che WuCheng-Yi WuChien-Hua HuangMin-Shan TsaiTsung-Chien LuEric ChouYen-Wen WuWei-Tien ChangWen-Jone ChenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Chih-Hung Wang Meng-Che Wu Cheng-Yi Wu Chien-Hua Huang Min-Shan Tsai Tsung-Chien Lu Eric Chou Yen-Wen Wu Wei-Tien Chang Wen-Jone Chen Blood gas phenotyping and tracheal intubation timing in adult in-hospital cardiac arrest: a retrospective cohort study
description	Abstract To investigate whether the optimal time to tracheal intubation (TTI) during cardiopulmonary resuscitation would differ by different blood gas phenotypes. Adult patients experiencing in-hospital cardiac arrest (IHCA) from 2006 to 2015 were retrospectively screened. Early intra-arrest blood gas analysis, performed within 10 min of resuscitation, was used to define different phenotypes. In total, 567 patients were included. Non-severe acidosis (pH≧7.15) was associated with favourable neurological outcome (odds ratio [OR]: 4.60, 95% confidence interval [CI] 1.63–12.95; p value = 0.004) and survival (OR: 3.25, 95% CI 1.72–6.15; p value < 0.001) in the multivariable logistic regression analyses. In the interaction analysis, normal blood gas phenotype (pH: 7.35–7.45, PCO2: 35–45 mm Hg, HCO3 − level: 22–26 mmol/L) × TTI ≦ 6.3 min (OR: 20.40, 95% CI 2.53–164.75; p value = 0.005) and non-severe acidosis × TTI ≦ 6.3 min (OR: 3.35, 95% CI 1.00–11.23; p value = 0.05) were associated with neurological recovery while metabolic acidosis × TTI ≦ 5.7 min (OR: 3.63, 95% CI 1.36–9.67; p value = 0.01) and hypercapnic acidosis × TTI ≦ 10.4 min (OR: 2.27, 95% CI 1.20–4.28; p value = 0.01) were associated with survival. Intra-arrest blood gas analysis may help guide TTI during for patients with IHCA.
format	article
author	Chih-Hung Wang Meng-Che Wu Cheng-Yi Wu Chien-Hua Huang Min-Shan Tsai Tsung-Chien Lu Eric Chou Yen-Wen Wu Wei-Tien Chang Wen-Jone Chen
author_facet	Chih-Hung Wang Meng-Che Wu Cheng-Yi Wu Chien-Hua Huang Min-Shan Tsai Tsung-Chien Lu Eric Chou Yen-Wen Wu Wei-Tien Chang Wen-Jone Chen
author_sort	Chih-Hung Wang
title	Blood gas phenotyping and tracheal intubation timing in adult in-hospital cardiac arrest: a retrospective cohort study
title_short	Blood gas phenotyping and tracheal intubation timing in adult in-hospital cardiac arrest: a retrospective cohort study
title_full	Blood gas phenotyping and tracheal intubation timing in adult in-hospital cardiac arrest: a retrospective cohort study
title_fullStr	Blood gas phenotyping and tracheal intubation timing in adult in-hospital cardiac arrest: a retrospective cohort study
title_full_unstemmed	Blood gas phenotyping and tracheal intubation timing in adult in-hospital cardiac arrest: a retrospective cohort study
title_sort	blood gas phenotyping and tracheal intubation timing in adult in-hospital cardiac arrest: a retrospective cohort study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/c5ebd3e08ff0495c98855a84159b6480
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Blood gas phenotyping and tracheal intubation timing in adult in-hospital cardiac arrest: a retrospective cohort study

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