Cardiac arrest & resuscitation
Association between the first post-resuscitation partial pressure of arterial carbon dioxide and neurologic outcomes in children with out-of-hospital cardiac arrest: a multicenter retrospective cohort study
Authors' conclusion
In this multicenter study of pediatric OHCA, we found no clear evidence of an independent association between first post-ROSC PaCO2 category and 30-day outcomes, although estimates were imprecise.
Study context
- Population
- Children <18 years with out-of-hospital cardiac arrest (OHCA) and return of spontaneous circulation (ROSC), Japanese OHCA registry (2014–2022); primary analysis restricted to first post-ROSC blood gas within 60 min
- Participants
- 215 children
- Exposure
- Hypocapnia or hypercapnia vs normocapnia on first post-ROSC PaCO2
- Hypocapnian = 27
- Normocapnian = 39reference
- Hypercapnian = 149
- Outcome
- Favorable neurologic outcome (Pediatric Cerebral Performance Category 1-3)
- Follow-up
- 30 days
Methodological detailsmulticentre registry, propensity score-based overlap weighting, hospital-clustered weighted GEE
- Multicentre registry
- Propensity score-based overlap weighting
- Hospital-clustered weighted GEE
Main finding
As reported in the abstract
Each group vs normocapniaAdjusted odds ratio (95% CI)
Hypocapnia
0.83(0.13–5.14)
Hypercapnia
1.46(0.25–8.68)
- Favorable neurologic outcome overall
- 41 (19.1%)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aOR (95% CI) | |
|---|---|---|
| 30-day survival · 30 daysHypocapnia vs Normocapnia · no clear evidence of association | 1.46 (0.26–8.01) | |
| 30-day survival · 30 daysHypercapnia vs Normocapnia · no clear evidence of association | 0.36 (0.09–1.46) | |
| 0.050.21520Adjusted odds ratio (log scale) |
- 30-day survival — 30-day survival overall
- 92 (42.8%)
Original publication
Association between the first post-resuscitation partial pressure of arterial carbon dioxide and neurologic outcomes in children with out-of-hospital cardiac arrest: a multicenter retrospective cohort study. Resuscitation. Published 11 September 2026. doi:10.
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