Cardiac Power Output independent factor Associated with CV related mortality after Cardiac arrest

Recent research sheds light on the significance of cardiac power output (CPO) within the first 8 hours following cardiac arrest (CA) as a potential predictor of intensive care unit (ICU) mortality, specifically related to cardiovascular failure. The study, conducted retrospectively on comatose adult survivors of CA, aimed to identify early hemodynamic markers associated with mortality in post-CA cardiovascular complications. This study was published in Resuscitation journal by Magni F. and colleagues.

Throughout the first 72 hours post-return of spontaneous circulation (ROSC), mean arterial pressure, cardiac output, and CPO were monitored at 8-hour intervals. The vasoactive-inotropic score was also recorded during this period. Patients who underwent extracorporeal cardiopulmonary resuscitation (ECPR), extracorporeal membrane oxygenation (ECMO), or intra-aortic balloon pump treatment were excluded from the study.

Among 217 patients analyzed, where the median age was 66 years and 65% were male, 142 (65.4%) patients succumbed in the ICU. Of these, 99 (69.7%) were attributed to neurological injury, while 43 (30.3%) were linked to cardiovascular-related causes.

The investigation found a significant association between CPO at 8 hours post-CA and cardiovascular-related mortality in the ICU. Comparison of CPO between survivors and non-survivors showed a statistically significant difference only at the 8-hour mark post-cardiac arrest. The study's multivariable analysis affirmed that CPO at 8 hours was independently linked to mortality related to cardiovascular complications after CA.

The findings suggest that CPO measured at the 8-hour mark post-CA may serve as an early indicator of mortality related to cardiovascular failure in ICU settings. Identifying such early hemodynamic markers could significantly aid in prognostication and timely intervention for post-CA complications, particularly targeting cardiovascular issues.

The study underscores the potential of CPO as an independent factor associated with cardiovascular-related mortality within the initial hours post-cardiac arrest. Further research and prospective studies could elucidate its role as a predictive marker and guide in the management of post-CA complications.

Reference:

Magni, F., Soloperto, R., Farinella, A., Bogossian, E., Halenarova, K., Pletschette, Z., Gozza, M., Labbe’, V., Ageno, W., Silvio TACCONE, F., & Annoni, F. Cardiac Power Output is associated with cardiovascular related mortality in the ICU in post-cardiac arrest patients. Resuscitation,2023;110062:110062. https://doi.org/10.1016/j.resuscitation.2023.110062