A systematic review and meta-analysis of the association between arterial carbon dioxide tension and outcomes after cardiac arrest.
MetadataShow full item record
INTRODUCTION: Arterial carbon dioxide tension (PaCO2) abnormalities are common after cardiac arrest (CA). Maintaining a normal PaCO2 makes physiological sense and is recommended as a therapeutic target after CA, but few studies have examined the association between PaCO2 and patient outcomes. This systematic review and meta-analysis aimed to assess the effect of a low or high PaCO2 on patient outcomes after CA. METHODS: We searched MEDLINE, EMBASE, CINAHL and Cochrane CENTRAL, for studies that evaluated the association between PaCO2 and outcomes after CA. The primary outcome was hospital survival. Secondary outcomes included neurological status at the end of each study's follow up period, hospital discharge destination and 30-day survival. Meta-analysis was conducted if statistical heterogeneity was low. RESULTS: The systematic review included nine studies; eight provided sufficient quantitative data for meta-analysis. Using PaCO2 cut-points of <35mmHg and >45mmHg to define hypo- and hypercarbia, normocarbia was associated with increased hospital survival (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.23, 1.38). Normocarbia was also associated with a good neurological outcome (cerebral performance category score 1 or 2) compared to hypercarbia (OR 1.69, 95% CI 1.13, 2.51) when the analysis also included an additional study with a slightly different definition for normocarbia (PaCO2 30-50mmHg). CONCLUSIONS: From the limited data it appears PaCO2 has an important U-shape association with survival and outcomes after CA, consistent with international resuscitation guidelines' recommendation that normocarbia be targeted during post-resuscitation care.
Showing items related by title, author, creator and subject.
Cardiopulmonary resuscitation quality and patient survival outcome in cardiac arrest: A systematic review and meta-analysisTalikowska, Milena; Tohira, Hideo; Finn, Judith (2015)Aim: To conduct a systematic review and meta-analysis to determine whether cardiopulmonary resuscitation (CPR) quality, as indicated by parameters such as chest compression depth, compression rate and compression fraction, ...
Hewitt, Katie; Binns, Colin; Scott, J.; Forbes, David (2012)Objective: To review the effect of pacifier use in healthy term infants on breastfeeding duration and the risk of Sudden Infant Death Syndrome (SIDS). Design: Two systematic reviews were conducted of published studies ...
Inconsistent results in meta-analyses for the prevention of falls are found between study-level data and patient-level dataHaines, T.; Hill, Anne-Marie (2011)Objective: This study seeks to examine whether existing study-level data meta-analysis approaches can be used to produce unbiased and precise effect estimates relative to meta-analyses conducted using patient-level data, ...