2026-06-30T02:01:37Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/270452025-12-17T01:17:34Zcom_20.500.12105_19586com_20.500.12105_2202col_20.500.12105_19587

00925njm 22002777a 4500 dc Izquierdo Ribas, Marc author López-Sobrino, Teresa author Moreno, Eva author de Diego, Oriol author Roca, Carlos author Cepas, Pedro author Jiménez-Trinidad, Francisco Rafael author Romeu, Nuria author Parellada, Marta author Pérez, Silvia author Freixa, Xavier author Ortiz-Pérez, José Tomás author García-Álvarez, Ana author Andrea, Rut author 2025-08 Mortality after an out-of-hospital cardiac arrest (OHCA) remains excessively high. The use of extracorporeal cardiopulmonary resuscitation at admission may improve survival, but selecting candidates for this therapy is challenging. Finding the best predictive biomarkers of severe hypoxic-ischemic brain injury (HIBI) on arrival might aid in the multimodal decision making. Our aim was to analyse the predictive value of the acid-base balance components in this scenario. This was a prospective observational study of OHCA patients that achieved return of spontaneous circulation without administration of HCO during resuscitation, admitted to an ICCU of a tertiary care centre. Point-of-care arterial biomarkers on arrival, including pH, pCO and HCO were analysed. The primary objective was severe HIBI. From 2019 to 2021, 50 OHCA patients were included, of which 17 (34%) suffered severe HIBI. Initial pH (6.99±0.20 vs. 7.14±0.15, P=0.007) and HCO values (14.13±3.24mEq/L vs. 17.97±4.28mEq/L, P=0.003) were significantly lower in severe HIBI patients, while no difference was observed regarding pCO (52.44±14.41mmHg vs. 51.38±13.38mmHg, P=0.801). HCO showed higher accuracy to predict severe HIBI than pH (AUC of 0.764 vs. 0.727), with a value of 16.5mmol/L as the best cut-off point. First HCO levels on admission of OHCA patients who achieved ROSC significantly predicted severe HIBI, unlike pCO, and showed even better accuracy than pH. Med Clin (Barc). 2025 Aug;165(2):106977. MEDICINA CLINICA 40412100 https://hdl.handle.net/20.500.12105/27045 Bicarbonate Bicarbonato ECPR ERCP Encefalopatía hipóxico-isquémica Hypoxic-ischemic brain injury Lactate Lactato Out-of-hospital cardiac arrest Parada cardiaca extrahospitalaria Predictive value of bicarbonate levels at admission for severe hypoxic-ischemic encephalopathy after out-of-hospital cardiac arrest.