Prognostic Value of Venous Blood Ammonia in Patients With Out-of-Hospital Cardiac Arrest

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著者

    • KASAI Asuka
    • Department of Emergency Care, Surugadai Nihon University Hospital
    • NAGAO Ken
    • Department of Cardiology, Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital
    • KIKUSHIMA Kimio
    • Department of Cardiology, Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital
    • WATANABE Kazuhiro
    • Department of Cardiology, Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital
    • TACHIBANA Eizo
    • Department of Cardiology, Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital
    • SOGA Taketomo
    • Department of Cardiology, Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital
    • MATSUZAKI Masakazu
    • Department of Cardiology, Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital
    • YAGI Tsukasa
    • Department of Cardiology, Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital

抄録

<b><i>Background:</i></b> Although studies have shown there is a correlation between increased blood ammonia level and hepatic encephalopathy, little information is available for patients with out-of-hospital cardiac arrest. <b><i>Methods and Results:</i></b> We did a prospective study of 357 adult patients with out-of-hospital cardiac arrest whose venous blood ammonia levels were measured on arrival at the emergency room. The primary endpoint was favorable of neurological outcome to hospital discharge. Of the 357 patients, 25 (7%) had a favorable neurological outcome. The venous ammonia levels were lower in the favorable neurological outcome group than in the unfavorable neurological outcome group (median, 50μg/dl vs. 210μg/dl, P<0.0001). The adjusted odds ratio of ammonia levels for favorable neurological outcome was 0.98 (95% confidence interval, 0.96-0.99; P<0.0001). The ammonia cutoff value of 93.0μg/dl for the identification of favorable neurological outcome had the highest combined sensitivity and specificity, and higher ammonia levels were associated with more accurate negative predictive values (for ammonia levels of 192.5μg/dl, the negative predictive value was 100%). Hyperammonemia was significantly related to patient variables that had a poor outcome (R=0.439, P<0.001). In addition, there was a significant correlation between venous ammonia level and arterial pH on emergency room arrival (R=0.633, P<0.0001). <b><i>Conclusions:</i></b> The measurement of ammonia was found to provide valuable information regarding neurological outcome to hospital discharge in adult patients with out-of-hospital cardiac arrest. (<i>Circ J</i> 2012; <b>76:</b> 891-899)<br>

収録刊行物

  • Circulation journal : official journal of the Japanese Circulation Society

    Circulation journal : official journal of the Japanese Circulation Society 76(4), 891-899, 2012-03-25

    一般社団法人 日本循環器学会

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各種コード

  • NII論文ID(NAID)
    10030131208
  • NII書誌ID(NCID)
    AA11591968
  • 本文言語コード
    ENG
  • 資料種別
    ART
  • ISSN
    13469843
  • データ提供元
    CJP書誌  J-STAGE 
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