Exploring correlations of low oxygen consumption, CO2 production and respiratory quotient with outcomes in patients after cardiac arrest1
Limited data suggests that low oxygen consumption (VO2), driven by mitochondrial injury is associated with mortality after cardiac arrest. Because measurement is challenging in the critically ill, post-arrest metabolism remains poorly characterized.
A study monitored VO2, carbon dioxide production (VCO2) and the respiratory quotient (RQ) in 17 post-arrest patients and explored their associations with outcome. The study used a gas exchange monitor to measure continuous VO2 and VCO2 in post-arrest patients treated with targeted temperature management. The data was used to evaluate the relationships between VO2, VCO2, RQ and the VO2:lactate ratio with survival.
There was a significant association between lower VO2 and mortality in the first 12 hours after ROSC, but not over 24 hours. A lower VO2:lactate ratio was also associated with mortality. Further research is needed to explore whether these parameters could have true value in assessing patient prognosis, or whether they could be potential targets for treatment.
1 From: Preliminary observations in systemic oxygen consumption during targeted temperature management after cardiac arrest; Amy Uber, Anne V. Grossestreuer, Catherine E. Ross, Parth V. Patel, Ambica Trehan, Michael W. Donnino, Katherine M. Berg. Published in Resuscitation, June 2018 Volume 127, Pages 89–94. © 2018 Elsevier B.V.