김희은 연구실은 분당서울대학교병원 기반의 응급의학 연구를 중심으로 심정지 환자의 소생술 고도화, REBOA를 포함한 혈역학적 중재, 심정지 후 신경학적 예후 예측 바이오마커 발굴 등을 수행하며, 일부 호흡 및 수면호흡장애 관련 임상 연구를 통해 중증 환자의 위험인자와 치료 전략을 폭넓게 탐구하고 있다.
Abstract 175: Prognostic Value Of Serum Phosphate Level In Elderly Post-cardiac Arrest Patients
Hee‐Eun Kim, Seung Min Park
IF 38.6
Circulation
A recent study has shown that serum phosphate (SP) may be a prognostic indicator for poor neurological outcomes in cardiac arrest patients. We aimed to confirm the hypothesis that a higher SP level predicts a poor neurological outcome of cardiac arrest, even in elderly patients. This retrospective observational study included post-cardiac arrest patients aged ≥65 years who were admitted to three hospitals in urban areas in South Korea from December 2013 to February 2020. Patient characteristics, laboratory values, and neurological outcomes at 28 days were collected from patients’ medical records. The primary outcome was poor neurological outcome (CPC scores 3-5) at 28 days. Of the 389 eligible patients, 334 had poor neurological outcomes. SP levels were higher in those with poor neurological outcomes (7.31 vs . 5.01, p<0.001). Multivariate logistic regression analysis showed that SP levels were independently associated with neurological outcomes. Higher SP levels are associated with poor neurological outcomes after cardiac arrest in the elderly population.
Abstract 188: Resuscitative Endovascular Occlusion Of The Aorta (REBOA) As A Mechanical Method For Increasing The Coronary Perfusion Pressure In Non-traumatic Out-of-hospital Cardiac Arrest Patients
Hee‐Eun Kim, Seung Min Park, Ki Chan Han
IF 38.6
Circulation
Goal: Resuscitative endovascular balloon occlusion of the aorta (REBOA), originally designed to block blood flow to the distal part of the aorta by placing a balloon in trauma patients, has recently been shown to increase coronary perfusion in cardiac arrest patients. This study evaluated REBOA in increasing the aortic pressure and coronary perfusion pressure (CPP) in non-traumatic out-of-hospital cardiac arrest (OHCA) patients. Methods: Adult OHCA patients with cerebral performance category 1 or 2 prior to cardiac arrest, and without evidence of aortic disease, were enrolled from Jan. to Dec. 2021. Aortic pressure and right atrial pressure were measured before and after balloon occlusion. CPP was calculated using the measured aortic and right atrial pressures, and the values before and after the balloon occlusion were compared. Results: Fifteen non-traumatic OHCA patients were enrolled in the study. The median call to balloon time was 46.0 (IQR, 38.0-54.5) min. The median CPP before and after balloon occlusion was 13.5 (IQR, 5.8-25.0) and 25.2 (IQR, 12.0-44.6) mmHg, respectively (P=0.001). The median increase in the estimated CPP after balloon occlusion was 86.7%. Conclusion: The results of this study suggest that REBOA may increase the CPP during cardiopulmonary resuscitation (CPR) in patients with non-traumatic OHCA.