Evaluation of changes in arterial blood gas parameters of patients undergoing cardiopulmonary resuscitation in the emergency department

Introduction and Objective: In the treatment of cardiac arrest, arterial blood gas analysis can guide therapeutic management during in-hospital treatment as well as during out-of-hospital cardiopulmonary resuscitation, thus serving as part of advanced cardiac life support monitoring and treatment. In this study, we aimed to determine the relationship between routine arterial blood gas parameters and acid-base findings immediately after the start of cardiopulmonary resuscitation and during cardiopulmonary resuscitation with return of spontaneous circulation and to determine the determinant role of arterial blood gas parameter changes in evaluating cardiopulmonary resuscitation effectiveness. Material and Method: The study was initiated with the approval of Afyonkarahisar Health Sciences University Clinical Research Ethics Committee dated 10.10.2023 and numbered 2023/430. Non-traumatic patients between the ages of 18- 90 who underwent in-hospital and out-of-hospital, cardiopulmonary resuscitation in the Emergency Department of Afyonkarahisar Health Sciences University Faculty of Medicine Hospital between 15.10.2023 and 15.09.2024 were included in the study. p<0.05 was considered statistically significant. Results: When blood gases taken at the beginning and after cardiopulmonary resuscitation were examined in patients with exitus outcome; changes in pH, Hgb, COHgb, Ca, lactate, BE and HCO3 levels were found to be statistically significant, and in the evaluation made in patients with return of spontaneous circulation, changes in pH, pCO2, pO2, Hgb, K, lactate and HCO3 levels were found to be statistically significant. Conclusion: In our study, the presence of additional disease, witnessed cardiac arrest, and the absence of a reversible cause were found to be indicators of poor prognosis. Among blood gas parameters, decreased pH, Hgb, Ca and HCO3 and increased COHgb, BE and Lactate levels were found to be poor prognosticators for the return of spontaneous circulation. Among blood gas parameters, increasing pH, pO2, Hgb and HCO3 and decreasing pCO2, K and Lactate values were found to be good prognostic indicators for the return of spontaneous circulation. Keywords: Arterial Blood Gas, Cardiac Arrest, Cardiopulmonary Resuscitation