Do carboxyhemoglobin and methemoglobin levels predict the return of
spontaneous circulation and prognosis of cardiac arrest patients?
Abstract
Introduction: Early prediction of return of spontaneous circulation
(ROSC) for cardiac arrest (CA) patients is a major challenge. This
study’s goal was to investigate the value of the carboxyhemoglobin
(COHb) and methemoglobin (MetHb) levels as a predictive marker for ROSC
and prognostic marker for patients who achieve ROSC. Methods: A total of
241 adult patients (109 female, 132 male) diagnosed as non-traumatic CA
were included in the study. The patients were divided into two groups
based on whether they achieved ROSC. Complete blood count parameters,
routine biochemistry measurements, coagulation parameters, and blood gas
analysis, and cardiac markers values were compared between the groups.
Results: COHb levels were significantly lower in the non-ROSC group
(0.71 ± 0.57%) than in the ROSC group (0.95 ± 0.76%) and in the
non-survival group (0.78 ± 0.53%) compared to the survivor group (1.45
± 1.31%) (p =0.002, 0.022 respectively). There was no significant
difference between the ROSC and non-ROSC groups and survivor group and
non-survivor groups in terms of MetHb levels (p = 0.769 and 0.668,
respectively). Conclusions: COHb levels in the blood gas analysis at the
time of admission could be used as a predictive marker for ROSC and
prognostic marker for the patients who achieved ROSC.