Objective

To evaluate the association between hyperoxia in the first 24 hours after in-hospital pediatric cardiac arrest and mortality and poor neurological outcome.

Methods

This is a retrospective cohort study of inpatients in a freestanding children’s hospital. We included all patients younger than 18 years of age with in-hospital cardiac arrest between December 2012 and December 2019, who achieved return of circulation (ROC) for longer than 20 minutes, survived at least 24 hours after cardiac arrest, and had documented PaO2 or SpO2 during the first 24 hours after ROC. Hyperoxia was defined as having at least one level of PaO2 above 200 mmHg in the first 24 hours after cardiac arrest.

Results

There were 187 patients who met eligibility criteria, of whom 48% had hyperoxia during the first 24 hours after cardiac arrest. In-hospital mortality was 41%, with similar mortality between oxygenation groups (hyperoxia 45% vs no hyperoxia 38%). We did not observe an association between hyperoxia and in-hospital mortality or poor neurological outcome after adjusting for confounders (odds ratio 1.2, 95% confidence interval 0.5–2.8). On sensitivity analysis using two additional cutoffs of PaO2 (>150 mmHg and > 300 mmHg), there was also no association with in-hospital mortality or poor neurological outcome after adjusting for confounders. Similarly, on multivariable logistic regression using SpO2 > 99% as the exposure, there was no difference in the frequency of death or poor neurological outcome at hospital discharge.

Conclusion

Hyperoxia after pediatric cardiac arrest was common and was not associated with worse in-hospital outcomes.

中文翻译：

---

小儿心脏骤停后的高氧：与生存和神经系统结局的关联

客观的

评估住院小儿心脏骤停后最初 24 小时内高氧与死亡率和不良神经系统预后之间的关系。

方法

这是一项针对独立儿童医院住院患者的回顾性队列研究。我们纳入了所有在 2012 年 12 月至 2019 年 12 月期间院内心脏骤停的 18 岁以下患者，这些患者达到循环恢复 (ROC) 超过 20 分钟，心脏骤停后至少存活 24 小时，并且记录了 PaO2或 ROC 后最初 24 小时内的 SpO2。高氧被定义为在心脏骤停后的最初 24 小时内至少有一个 PaO2 水平高于 200 mmHg。

结果

有 187 名患者符合资格标准，其中 48% 在心脏骤停后的前 24 小时内出现高氧。住院死亡率为 41%，氧合组之间的死亡率相似（高氧 45% vs 无高氧 38%）。在调整混杂因素后，我们没有观察到高氧与住院死亡率或神经系统预后不良之间的关联（优势比 1.2，95% 置信区间 0.5-2.8）。在使用两个额外的 PaO2 截止值（>150 mmHg 和 >300 mmHg）进行敏感性分析时，在调整混杂因素后，与住院死亡率或不良神经系统预后无关。同样，在使用 SpO2 > 99% 作为暴露的多变量逻辑回归中，出院时死亡或神经系统预后不良的频率没有差异。

结论

小儿心脏骤停后的高氧很常见，并且与较差的住院结局无关。