KSCCM
Search
- Page Path
- HOME > Search
Original Article
- Blood Gases during Cardiopulmonary Resuscitation in Predicting Arrest Cause between Primary Cardiac Arrest and Asphyxial Arrest
- Sei Jong Bae, Byung Kook Lee, Ki Tae Kim, Kyung Woon Jeung, Hyoung Youn Lee, Yong Hun Jung, Geo Sung Lee, Sun Pyo Kim, Seung Joon Lee
- Korean J Crit Care Med. 2013;28(1):33-40.
- DOI: https://doi.org/10.4266/kjccm.2013.28.1.33
- 2,515 View
- 22 Download
-
Abstract
PDF - BACKGROUND
If acid-base status and electrolytes on blood gases during cardiopulmonary resuscitation (CPR) differ between the arrest causes, this difference may aid in differentiating the arrest cause. We sought to assess the ability of blood gases during CPR to predict the arrest cause between primary cardiac arrest and asphyxial arrest.
METHODS
A retrospective study was conducted on adult out-of-hospital cardiac arrest patients for whom blood gas analysis was performed during CPR on emergency department arrival. Patients were divided into two groups according to the arrest cause: a primary cardiac arrest group and an asphyxial arrest group. Acid-base status and electrolytes during CPR were compared between the two groups.
RESULTS
Presumed arterial samples showed higher potassium in the asphyxial arrest group (p < 0.001). On the other hand, presumed venous samples showed higher potassium (p = 0.001) and PCO2 (p < 0.001) and lower pH (p = 0.008) and oxygen saturation (p = 0.01) in the asphyxial arrest group. Multiple logistic regression analyses revealed that arterial potassium (OR 5.207, 95% CI 1.430-18.964, p = 0.012) and venous PCO2 (OR 1.049, 95% CI 1.021-1.078, p < 0.001) were independent predictors of asphyxial arrest. Receiver operating characteristic curve analyses indicated an optimal cut-off value for arterial potassium of 6.1 mEq/L (sensitivity 100% and specificity 86.4%) and for venous PCO2 of 70.9 mmHg (sensitivity 84.6% and specificity 65.9%).
CONCLUSIONS
The present study indicates that blood gases during CPR can be used to predict the arrest cause. These findings should be confirmed through further studies.
Case Report
- Severe Hyperkalemia without Typical Electrocardiographic Manifestations: A case report
- Sang Beom Nam, Hee Koo Yoo
- Korean J Crit Care Med. 1999;14(1):42-46.
- 1,678 View
- 60 Download
-
Abstract
PDF
- Severe hyperkalemia can induce life threatening cardiac rhythm disturbances, and usually produce classic electrocardiographic (EKG) manifestations. We report a case of severe hyperkalemia in which the EKG did not reveal the expected alterations. The patient was a 57-year-old man with adenocarcinoma of stomach. There were no significant abnormal findings in laboratory analysis, chest X-ray and EKG. His preoperative medications for hypertension consisted of furosemide, amiloride and enalapril. The tests for serum potassium concentration ([K ]) were performed on 20 and 7 days before the operation and the results were 4.5 and 4.9 mEq/l, respectively. Just after induction of anesthesia, we tried the blood gas and electrolyte analysis and the result revealed high [K ] of 8.5 mEq/l, but EKG did not show typical phenotype of hyperkalemia at that time. His intraoperative and postoperative courses were not eventful.
Original Article
- Changes of Sodium, Potassium, Chloride and Bicarbonateion Concentrations in Apneic Rabbits
- Hyun Jung Kim, Kwang Won Yum, Yong Rak Kim
- Korean J Crit Care Med. 1998;13(2):186-193.
- 1,585 View
- 7 Download
-
Abstract
PDF
- BACKGOUND: During apnea, as in any other acid-base disturbance, ion exchanges between intra- and extracellular compartments are expected, but few studies have reported such findings. The purpose of this study was to observe serum sodium, potassium, chloride and bicarbonate concentrations during apnea until death.
METHODS
Seventeen New Zealand White Rabbits (weight 2.0~3.0 kg) were subjected to apneic oxygenation. Then we measured heart rate, blood pressure, intracranial pressure, arterial blood gas analyses and serum electrolytes (sodium, potassium, chloride and bicarbonate) concentrations during apnea until death.
RESULTS
Heart rate decreased because of sinus bradyarrythmia at 10 minutes after apnea and thereafter continued to increase. Blood pressure increased up to 30 minutes after apnea and thereafter continued to decrease. Intracranial pressure consistently increased during apnea. Serum bicarbonate and chloride ion concentrations showed reciprocal changes, but there was no significant correlation. Serum sodium and potassium concentrations increased up to 40 minutes and 30 minutes respectively, and thereafter decreased until death. All serum ion concentrations were within normal limits.
CONCLUSION
The serum sodium, potassium, chloride and bicarbonate concentrations were maintained within normal limits during apneic oxygenation until death.
First
Prev
