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Treffer: Hypoxic hepatitis after out-of-hospital cardiac arrest: Incidence, determinants and prognosis.

Title:
Hypoxic hepatitis after out-of-hospital cardiac arrest: Incidence, determinants and prognosis.
Authors:
Champigneulle B; Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France. Electronic address: benoit.champigneulle@aphp.fr., Geri G; Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France; INSERM U970 Sudden Death Expertise Center, Paris Cardiovascular Research Center, Paris, France., Bougouin W; Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France; INSERM U970 Sudden Death Expertise Center, Paris Cardiovascular Research Center, Paris, France., Dumas F; Paris Descartes University, Sorbonne Paris Cité, Paris, France; Emergency Department, Cochin University Hospital, AP-HP, Paris, France; INSERM U970 Sudden Death Expertise Center, Paris Cardiovascular Research Center, Paris, France., Arnaout M; Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France., Zafrani L; Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France., Pène F; Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France., Charpentier J; Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France., Mira JP; Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France., Cariou A; Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France; INSERM U970 Sudden Death Expertise Center, Paris Cardiovascular Research Center, Paris, France.
Source:
Resuscitation [Resuscitation] 2016 Jun; Vol. 103, pp. 60-65. Date of Electronic Publication: 2016 Apr 08.
Publication Type:
Journal Article; Observational Study
Language:
English
Journal Info:
Publisher: Elsevier/north-Holland Biomedical Press Country of Publication: Ireland NLM ID: 0332173 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-1570 (Electronic) Linking ISSN: 03009572 NLM ISO Abbreviation: Resuscitation Subsets: MEDLINE
Imprint Name(s):
Publication: Limerick : Elsevier/north-Holland Biomedical Press
Original Publication: London, Middlesex Pub. Co.
MeSH Terms:
Hepatitis/*epidemiology , Out-of-Hospital Cardiac Arrest/*complications, Aged ; Alanine Transaminase/blood ; Cardiopulmonary Resuscitation ; Female ; Hepatitis/complications ; Hepatitis/enzymology ; Humans ; Hypoglycemia/complications ; Hypoxia/complications ; Incidence ; Intensive Care Units/statistics & numerical data ; Male ; Middle Aged ; Multivariate Analysis ; Out-of-Hospital Cardiac Arrest/mortality ; Time Factors
Contributed Indexing:
Keywords: Cardiac arrest; Hypoxic hepatitis; Liver failure; Post-cardiac arrest syndrome; Shock liver
Substance Nomenclature:
EC 2.6.1.2 (Alanine Transaminase)
Entry Date(s):
Date Created: 20160413 Date Completed: 20171023 Latest Revision: 20171222
Update Code:
20250114
DOI:
10.1016/j.resuscitation.2016.03.021
PMID:
27068401
Database:
MEDLINE

Weitere Informationen

Aim: Hypoxic hepatitis (HH) may complicate the course of resuscitated out-of-hospital cardiac arrest (OHCA) patients admitted in intensive care unit (ICU). Aims of this study were to assess the prevalence of HH, and to describe the factors associated with HH occurrence and outcome.
Methods: We conducted an observational study over a 6-year period (2009-2014) in a cardiac arrest center. All non-traumatic OHCA patients admitted in the ICU after return of spontaneous circulation (ROSC) and who survived more than 24h were included. HH was defined as an elevation of alanine aminotransferase over 20 times the upper limit of normal during the first 72h after OHCA. Factors associated with HH and ICU mortality were picked up by multivariate logistic regression.
Results: Among the 632 OHCA patients included in the study, HH was observed in 72 patients (11.4% (95% CI: 9.0%, 14.1%)). In multivariate analysis, time from collapse to ROSC [OR 1.02 per additional minute; 95% CI (1.00, 1.04); p=0.01], male gender [OR 0.53; 95% CI (0.29, 0.95); p=0.03] and initial shockable rhythm [OR 0.35; 95% CI (0.19, 0.65); p<0.01] were associated with HH occurrence. After adjustment for confounding factors, HH was associated with ICU mortality [OR 4.39; 95% CI (1.71, 11.26); p<0.01] and this association persisted even if occurrence of a post-CA shock was considered in the statistical model [OR 3.63; 95% CI (1.39, 9.48); p=0.01].
Conclusions: HH is not a rare complication after OHCA. This complication is mainly triggered by the duration of resuscitation and is associated with increased ICU mortality.
(Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)