Cardiac arrest & resuscitation
High Normocapnia and Better Functional Outcome in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation After Out-of-Hospital Cardiac Arrest
Authors' conclusion
In adult patients with nontraumatic injury with OHCA and receiving VA-ECMO, high normocapnia was associated with better functional outcomes than low normocapnia in both initial and 24-hour Paco2 analyses.
Study context
- Population
- Adults with nontraumatic out-of-hospital cardiac arrest (OHCA) receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO), PaCO2 measured within 6 h of initiation (initial set) and 18 to 30 h after (24-hour set), 2014 to 20201,454 initial set
- Exposure
- PaCO2 categories vs high normocapnia, initial and at 24 h
- Outcome
- Favorable functional outcome
- Follow-up
- 30 days
Methodological detailsmulticentre, multivariable logistic regression
- Multicentre
- Multivariable logistic regression
Main finding
As reported in the abstract
Favorable functional outcome at 30 days
Low normocapnia vs High normocapniaAdjusted odds ratio (95% CI)
Initial PaCO2
0.59(0.38–0.89)
24-hour PaCO2
0.56(0.33–0.95)
Observational data: associations, not effects.
Further findings
PaCO2 trajectories from initial to 24-hour levels (exploratory)
- Trajectories ending in high normocapnia had higher proportions of favorable functional outcome than those ending in low normocapnia, regardless of initial PaCO2
- Exploratory analyses
Original publication
High Normocapnia and Better Functional Outcome in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation After Out-of-Hospital Cardiac Arrest. Chest. Published 19 January 2025. doi:10.
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