2026-06-30T02:01:40Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/270452025-12-17T01:17:34Zcom_20.500.12105_19586com_20.500.12105_2202col_20.500.12105_19587
Repisalud
author
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
2025-12-16T10:41:19Z
2025-12-16T10:41:19Z
2025-08
Med Clin (Barc). 2025 Aug;165(2):106977.
MEDICINA CLINICA
40412100
https://hdl.handle.net/20.500.12105/27045
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.
eng
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.
research article
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URL
https://repisalud.isciii.es/bitstreams/fcc93e9b-4570-4678-9d90-86b6b5a6119c/download
File
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98c9cddfc4ff9a4494b2c5e3b40fe630
153490
application/pdf
Predictive value of bicarbonate levels_Med Clin_2025.pdf