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How much oxygen in adult cardiac arrest?

Although experimental studies have suggested that a high arterial oxygen pressure (PaO(2)) might aggravate post-anoxic brain injury, clinical studies in patients resuscitated from cardiac arrest (CA) have given conflicting results. Some studies found that a PaO(2) of more than 300 mm Hg (hyperoxemia...

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Autores principales: Dell’Anna, Antonio Maria, Lamanna, Irene, Vincent, Jean-Louis, Taccone, Fabicpro Silvio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520204/
https://www.ncbi.nlm.nih.gov/pubmed/25636001
http://dx.doi.org/10.1186/s13054-014-0555-4
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author Dell’Anna, Antonio Maria
Lamanna, Irene
Vincent, Jean-Louis
Taccone, Fabicpro Silvio
author_facet Dell’Anna, Antonio Maria
Lamanna, Irene
Vincent, Jean-Louis
Taccone, Fabicpro Silvio
author_sort Dell’Anna, Antonio Maria
collection PubMed
description Although experimental studies have suggested that a high arterial oxygen pressure (PaO(2)) might aggravate post-anoxic brain injury, clinical studies in patients resuscitated from cardiac arrest (CA) have given conflicting results. Some studies found that a PaO(2) of more than 300 mm Hg (hyperoxemia) was an independent predictor of poor outcome, but others reported no association between blood oxygenation and neurological recovery in this setting. In this article, we review the potential mechanisms of oxygen toxicity after CA, animal data available in this field, and key human studies dealing with the impact of oxygen management in CA patients, highlighting some potential confounders and limitations and indicating future areas of research in this field. From the currently available literature, high oxygen concentrations during cardiopulmonary resuscitation seem preferable, whereas hyperoxemia should be avoided in the post-CA care. A specific threshold for oxygen toxicity has not yet been identified. The mechanisms of oxygen toxicity after CA, such as seizure development, reactive oxygen species production, and the development of organ dysfunction, need to be further evaluated in prospective studies.
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spelling pubmed-45202042015-07-31 How much oxygen in adult cardiac arrest? Dell’Anna, Antonio Maria Lamanna, Irene Vincent, Jean-Louis Taccone, Fabicpro Silvio Crit Care Viewpoint Although experimental studies have suggested that a high arterial oxygen pressure (PaO(2)) might aggravate post-anoxic brain injury, clinical studies in patients resuscitated from cardiac arrest (CA) have given conflicting results. Some studies found that a PaO(2) of more than 300 mm Hg (hyperoxemia) was an independent predictor of poor outcome, but others reported no association between blood oxygenation and neurological recovery in this setting. In this article, we review the potential mechanisms of oxygen toxicity after CA, animal data available in this field, and key human studies dealing with the impact of oxygen management in CA patients, highlighting some potential confounders and limitations and indicating future areas of research in this field. From the currently available literature, high oxygen concentrations during cardiopulmonary resuscitation seem preferable, whereas hyperoxemia should be avoided in the post-CA care. A specific threshold for oxygen toxicity has not yet been identified. The mechanisms of oxygen toxicity after CA, such as seizure development, reactive oxygen species production, and the development of organ dysfunction, need to be further evaluated in prospective studies. BioMed Central 2014-10-07 2014 /pmc/articles/PMC4520204/ /pubmed/25636001 http://dx.doi.org/10.1186/s13054-014-0555-4 Text en © Dell'Anna et al.; licensee BioMed Central Ltd. 2014 The licensee has exclusive rights to distribute this article, in any medium, for 12 months following its publication. After this time, the article is available under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Viewpoint
Dell’Anna, Antonio Maria
Lamanna, Irene
Vincent, Jean-Louis
Taccone, Fabicpro Silvio
How much oxygen in adult cardiac arrest?
title How much oxygen in adult cardiac arrest?
title_full How much oxygen in adult cardiac arrest?
title_fullStr How much oxygen in adult cardiac arrest?
title_full_unstemmed How much oxygen in adult cardiac arrest?
title_short How much oxygen in adult cardiac arrest?
title_sort how much oxygen in adult cardiac arrest?
topic Viewpoint
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520204/
https://www.ncbi.nlm.nih.gov/pubmed/25636001
http://dx.doi.org/10.1186/s13054-014-0555-4
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