The association between early hemodynamic variables and outcome in normothermic comatose patients following cardiac arrest.
BACKGROUND
Currently, few data exist on the association between post-cardiac arrest hemodynamic function and outcome. In this explorative, retrospective analysis, the association between hemodynamic variables during the first 24 h after intensive care unit admission and functional outcome at day 28 was evaluated in 153 normothermic comatose patients following a cardiac arrest.


METHODS
Medical records of a multidisciplinary intensive care unit were reviewed for comatose patients (Glasgow Coma Scale < or = 9) admitted to the intensive care unit after successful resuscitation from an in- or an out-of-hospital cardiac arrest. The hourly variable time integral of hemodynamic variables during the first 24 h after admission was calculated. At day 28, outcome was assessed as favorable or adverse based on a Cerebral Performance Category of 1-2 and 3-5, respectively. Bi- and multivariate regression models adjusted for relevant confounding variables were used to evaluate the association between hemodynamic variables and functional outcome.


RESULTS
One hundred and fifty-three normothermic comatose patients were admitted after a cardiac arrest, of whom 64 (42%) experienced a favorable outcome. Neither in the adjusted bivariate models (r(2), 0.61-0.78) nor in the adjusted multivariate model (r(2), 0.62-0.73) was the hourly variable time integral of any hemodynamic variable during the first 24 h after intensive care unit admission associated with functional patient outcome at day 28 in all patients as well as in patients after an in- or an out-of-hospital cardiac arrest.


CONCLUSIONS
Commonly measured hemodynamic variables during the first 24 h following intensive care unit admission due to a cardiac arrest do not appear to be associated with the functional outcome at day 28.
Torgersen
C
C
Department of Intensive Care Medicine, Inselspital, Medical University of Bern, Bern, Switzerland.
Schmittinger
C A
CA
Takala
J
J
Jakob
S M
SM
Dünser
M W
MW
D000368:Aged; D016887:Cardiopulmonary Resuscitation; D003128:Coma / Q000209:etiology* / Q000503:physiopathology*; D003422:Critical Care; D003627:Data Interpretation, Statistical; D023381:Endpoint Determination; D005260:Female; D015600:Glasgow Coma Scale; D006323:Heart Arrest / Q000150:complications* / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome