Correlation between blood gas analysis and cardiac gas on immediate postmortem computed tomography after cardiopulmonary resuscitation. (March 2020)

• Record Type: Journal Article
• Authors: Hagita, Tomoaki; Shiotani, Seiji; Kuma, Natsuyo; Ogasawara, Nobuhiko
• Is Part Of: Forensic Imaging. Volume 20(2020)
• Publication Date: 2020-03
• Subjects: Postmortem computed tomography -- Cardiopulmonary resuscitation -- Cardiac gas -- Blood gas analysis -- Carbon dioxide; Abbreviations: BGA blood gas analysis -- CG cardiac gas -- CO2 carbon dioxide -- CPA cardiopulmonary arrest -- CPR cardiopulmonary resuscitation -- CT computed tomography -- CVG cardiovascular gas -- ED emergency department -- PaCO2 partial pressure of arterial carbon dioxide -- PM postmortem -- PMCT postmortem computed tomography -- PvCO2 partial pressure of venous carbon dioxide -- RA right atrium -- RV right ventricle
• DOI: 10.1016/j.fri.2020.200358
• Languages: English
• ISSNs: 2666-2256

Abstract

Highlights: The correlation between blood gas analysis (BGA) and cardiac gas (CG) on immediate postmortem computed tomography (PMCT) was investigated. Both pH and partial pressure of arterial oxygen (PaO2) were significantly lower in patients with CG than those without it on immediate PMCT. PaCO2 was significantly higher in patients with CG than those without it on immediate PMCT, PaCO2 is related to CG on immediate PMCT. Abstract: Purpose: Cardiac gas (CG) is a characteristic postmortem computed tomography (PMCT) finding. This study investigated the correlation between blood gas analysis (BGA) and CG presence on immediate PMCT after cardiopulmonary resuscitation (CPR). Materials and methods: We enrolled 132 nontraumatic cardiopulmonary arrest (CPA) patients (69 males, 63 females) who were transported to our hospital and could not be resuscitated. They underwent arterial BGA during CPR and immediate PMCT after failed resuscitation and were classified into a CG-negative or a CG-positive group on the basis of computed tomography (CT) findings. We also compared BGA values between the two groups. Results: The mean age of the 132 people was 81.4 ± 11.8 years. CG on immediate PMCT was found in 60 patients (45.5%), with gas in the right atrium (RA) in 31 patients (23.5%) and in the right ventricle (RV) in 51 patients (38.8%). We did not detect gas in the left atrium (LA) or left ventricle (LV) in any of the patients. Both pH and partial pressure of arterial oxygen (PaO2 ) were significantly lower and partial pressure of arterial carbon dioxide (PaCO2 ) significantly higher in the CG-positive group compared to the CG-negative group. Conclusion: CG occurrence on immediate PMCT post-CPR might be related to high PaCO2 levels.