title: How much oxygen in adult cardiac arrest?
abstract: Although experimental studies have suggested that a high arterial oxygen pressure (PaO2) might aggravate post-anoxic brain injury, clinical studies in patients resuscitated from cardiac arrest (CA) have given conflicting results. Some studies found that a PaO2 of more than 300 mm Hg (hyperoxemia) was an independent predictor of poor outcome, but others reported no association between blood oxygenation and neurological recovery in this setting. In this article, we review the potential mechanisms of oxygen toxicity after CA, animal data available in this field, and key human studies dealing with the impact of oxygen management in CA patients, highlighting some potential confounders and limitations and indicating future areas of research in this field. From the currently available literature, high oxygen concentrations during cardiopulmonary resuscitation seem preferable, whereas hyperoxemia should be avoided in the post-CA care. A specific threshold for oxygen toxicity has not yet been identified. The mechanisms of oxygen toxicity after CA, such as seizure development, reactive oxygen species production, and the development of organ dysfunction, need to be further evaluated in prospective studies.
authors: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Belgium, Route de Lennik 808, 1070, Brussels, Belgium. anthosdel@yahoo.it.
authors: Antonio Maria
authors: AM
authors: Dell'Anna
authors: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Belgium, Route de Lennik 808, 1070, Brussels, Belgium. irenelamanna82@gmail.com.
authors: Irene
authors: I
authors: Lamanna
authors: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Belgium, Route de Lennik 808, 1070, Brussels, Belgium. jlvincen@ulb.ac.be.
authors: Jean-Louis
authors: JL
authors: Vincent
authors: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Belgium, Route de Lennik 808, 1070, Brussels, Belgium. ftaccone@ulb.ac.be.
authors: Fabicpro Silvio
authors: FS
authors: Taccone
mesh_terms: D000328:Adult; D000818:Animals; D001784:Blood Gas Analysis; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D006323:Heart Arrest / Q000097:blood* / Q000401:mortality; D006801:Humans; D018496:Hyperoxia / Q000150:complications; D002534:Hypoxia, Brain; D010100:Oxygen / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood
chemical_list: D010100:Oxygen
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