Resuscitation
August 14, 2026 · via Europe PMC
Arterial blood gas parameters during cardiopulmonary resuscitation and sustained return of spontaneous circulation in out-of-hospital cardiac arrest: a preplanned secondary analysis of the AMCPR trial.
Kim JS, Kim YJ, Kim WY.
AI summary — for doctors, generated from the abstract only
Higher arterial oxygen during CPR was associated with sustained ROSC, though partly confounded by resuscitation duration.
What was studied
Preplanned secondary analysis of the AMCPR trial with 251 OHCA patients having arterial blood gases at arterial line placement and at 10 and 20 minutes.
Key findings
- 93 patients (37.1%) achieved sustained ROSC.
- In 135 patients with a 10-minute sample, higher PaO2 was independently associated with sustained ROSC (aOR 1.02; 95% CI 1.01-1.02).
- Exploratory cut-offs included PaO2 above 60 mmHg (other cutoffs cut off in the abstract).
Clinical relevance
Arterial lines during CPR could provide physiologic information beyond hemodynamics.
Who should care
Limitations
Single tertiary center, sample loss at 10 minutes, and PaO2 is partly entangled with CPR duration.
Intra-arrest blood gases are not recommended routinely; this is a research signal rather than a guide to treatment.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Aim
Arterial blood gas analysis (ABGA) is not routinely performed during cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA), and is not recommended by current guidelines. This preplanned secondary analysis of the Augmented-Medication CardioPulmonary Resuscitation (AMCPR) trial evaluated whether intra-arrest PaO2 was associated with sustained return of spontaneous circulation (ROSC).
Methods
Adult OHCA patients treated at a tertiary emergency department were included. ABGA samples were obtained immediately after ultrasound-confirmed arterial catheterization and 10 and 20 min after the start of ED resuscitation; parameters included pH, PaO2, PaCO2, bicarbonate (HCO3-), and lactate. PaO2 at the protocol-defined 10-min time point was the primary exposure and sustained ROSC the outcome; other parameters and sampling times were examined as secondary exploratory analyses.
Results
Among 251 patients, 93 (37.1%) achieved sustained ROSC and 135 had a 10-min sample. In the primary analysis of these 135 patients, higher PaO2 at 10 min was independently associated with sustained ROSC (adjusted odds ratio 1.02; 95% CI 1.01-1.02). In secondary exploratory analyses, optimal cut-offs were PaO2 >60 mmHg and PaCO2 <70 mmHg, whereas pH and lactate showed no consistent pattern. Twenty patients (8.0%) survived to discharge and 2 (0.8%) had a favorable neurological outcome.
Conclusion
During monitored ED resuscitation for OHCA, higher intra-arrest PaO2 was associated with sustained ROSC, although this association was only partly separable from resuscitation duration. Arterial line placement during CPR may provide physiologic information beyond hemodynamic monitoring.
DOI
10.1016/j.resuscitation.2026.111266
PMID
42600769
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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