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The Impact of Severity of Acute Respiratory Distress Syndrome Following Cardiac Arrest on Neurologic Outcomes

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Abstract
The aim of this study was to evaluate the incidence and determinants of acute respiratory distress syndrome
(ARDS) after cardiac arrest (CA). We conducted an observational, retrospective cohort study with consecutive
adult out-of-hospital and in-hospital (occurred only in the emergency department, ED) CA survivors from our ED.
Development of ARDS was identified by results of arterial blood gases, chest images, and transthoracic echocardiography
according to the Berlin definition. The primary outcome was the poor neurologic outcome, defined
as cerebral performance category q3 at 28 days, and secondary outcomes were 28-day mortality, recovery rate
from ARDS, duration of mechanical ventilator use, and length of stay. Among 295 enrolled patients, 30 patients
who received extracorporeal membrane oxygenation and 19 patents who had cardiogenic pulmonary edema were
excluded. ARDS had developed in 119 (48.4%) patients on admission (mild 20 [16.8%], moderate 48 [40.3%],
and severe 51 [42.9%]) and 54 (45.4%) patients recovered before hospital discharge. Development of ARDS was
associated with poor neurologic outcomes at 28 days (adjusted hazard ratio (HR) 1.44 [95% confidence interval
(CI): 1.05?1.98]). Moreover, more severe ARDS was associated with a higher risk of poor neurological outcomes
(mild: reference; moderate: adjusted HR 1.66 [95% CI: 1.10?2.49]; and severe: adjusted HR 1.76 [95% CI: 1.16?
2.65]). Therefore, development of ARDS after CA was associated with unfavorable neurologic outcomes and had
a linear association with ARDS severity. Early recognition and proper management of ARDS may be useful
during post-CA care.
Author(s)
김무열김원영김윤정김준성손창환안신유승목
Issued Date
2021
Type
Article
Keyword
cardiac arrestICU managementrisk factorsemergency medicine
DOI
10.1089/ther.2019.0047
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8270
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_crossref_primary_10_1089_ther_2019_0047&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,The%20Impact%20of%20Severity%20of%20Acute%20Respiratory%20Distress%20Syndrome%20Following%20Cardiac%20Arrest%20on%20Neurologic%20Outcomes&offset=0&pcAvailability=true
Publisher
Therapeutic Hypothermia and Temperature Management
Location
미국
Language
영어
ISSN
2153-7658
Citation Volume
11
Citation Number
2
Citation Start Page
96
Citation End Page
102
Appears in Collections:
Medicine > Medicine
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