title: The significance of albumin corrected anion gap in patients with cardiopulmonary arrest.
abstract: OBJECTIVE
  The reliable parameter, which can be obtained easily and quickly, is necessary to predict the return of spontaneous circulation (ROSC) of patients with cardiopulmonary arrest (CPA) in the emergency situation. In this study, we evaluated the significance of albumin corrected anion gap (ACAG) for the prediction of ROSC in patients with CPA.
  
  
  METHODS
  In 166 patients with CPA between January 2009 and December 2010, 132 patients could be analyzed retrospectively. We compared acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment(SOFA) score, anion gap (AG) and ACAG levels between patients with/without ROSC and evaluated the significance of AG and ACAG to predict ROSC in patients with CPA.
  
  
  RESULTS
  Both AG and ACAG were significantly lower in patients with ROSC than in patients without ROSC. Both AG and ACAG had the relation with APACHE II and SOFA scores, however, coefficients of correlation with APACHE II and SOFA score were higher in ACAG (r = 0.506) than in AG (r = 0.482). The sensitivity, specificity, positive predictive value, and negative predictive value of ACAG for the prediction of ROSC in patients with CPA were better than those of AG.
  
  
  CONCLUSIONS
  Our study shows that both AG and ACAG have the relation with ROSC and ACAG is better to predict the ROSC following CPR in patients with CPA compared with AG. ACAG can be easily obtained in the emergency situation, and ACAG is a useful parameter to predict ROSC in patients with CPA.
authors.affiliation: Department of Emergency Medicine, Gunma University Gradu ate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Oshima
authors.forename: Kazumi
authors.initials: K
authors.lastname: Furukawa
authors.forename: Takuro
authors.initials: T
authors.lastname: Nakamura
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ohyama
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Tamura
mesh_terms: D018806:APACHE; D000136:Acid-Base Equilibrium; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004630:Emergencies; D005260:Female; D006323:Heart Arrest / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D063305:Organ Dysfunction Scores; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D000075462:Serum Albumin, Human; D016896:Treatment Outcome
chemical_list: C422455:ALB protein, human; D015415:Biomarkers; D012709:Serum Albumin; D000075462:Serum Albumin, Human