{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T08:57:32Z","timestamp":1765961852162,"version":"3.41.2"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:00:00Z","timestamp":1734652800000},"content-version":"vor","delay-in-days":354,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The optimal arterial partial pressure of carbon dioxide (PaCO<jats:sub>2<\/jats:sub>) for patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) remains unknown. We aimed to investigate the association between post\u2010resuscitation PaCO<jats:sub>2<\/jats:sub> and neurological outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study analyzed data from the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan, a multicenter registry study across 36 hospitals in Japan, including patients with out\u2010of\u2010hospital cardiac arrest (OHCA) admitted to intensive care units (ICU) after ECPR between 2013 and 2018. Good PaCO<jats:sub>2<\/jats:sub> management status was defined as a PaCO<jats:sub>2<\/jats:sub> value of 35\u201345\u2009mmHg. We classified patients into four groups (poor\u2013poor, poor\u2013good, good\u2013poor, and good\u2013good) according to their PaCO<jats:sub>2<\/jats:sub> management status upon admission at the ICU and the following day. The primary outcome was a favorable neurological outcome, defined as cerebral performance category 1 or 2, 30\u2009days after cardiac arrest. The secondary outcome was survival 30\u2009days after cardiac arrest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We classified 885 eligible patients into poor\u2013poor (<jats:italic>n<\/jats:italic>\u2009=\u2009361), poor\u2013good (<jats:italic>n<\/jats:italic>\u2009=\u2009231), good\u2013poor (<jats:italic>n<\/jats:italic>\u2009=\u2009155), and good\u2013good (<jats:italic>n<\/jats:italic>\u2009=\u2009138) groups. No significant association was observed between PaCO<jats:sub>2<\/jats:sub> management and favorable 30\u2010day neurological outcomes. Compared with the poor\u2013poor group, the poor\u2013good, good\u2013poor, and good\u2013good groups had adjusted odds ratios of 0.87 (95% confidence interval, 0.52\u20131.44), 1.17 (0.65\u20132.05), and 0.95 (0.51\u20131.73), respectively. The 30\u2010day survival rates among the four groups did not differ significantly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PaCO<jats:sub>2<\/jats:sub> values were not significantly associated with 30\u2010day neurological outcomes or survival of patients with OHCA after ECPR.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ams2.70021","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T11:04:44Z","timestamp":1734692684000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association between PaCO<sub>2<\/sub> and outcomes in patients who underwent extracorporeal cardiopulmonary resuscitation for out\u2010of\u2010hospital cardiac arrest"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1986-6148","authenticated-orcid":false,"given":"Ayumi","family":"Kawakami","sequence":"first","affiliation":[{"name":"Tertiary Emergency Medical Center Tokyo Metropolitan Bokutoh Hospital  Sumida\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5651-1449","authenticated-orcid":false,"given":"Keita","family":"Shibahashi","sequence":"additional","affiliation":[{"name":"Tertiary Emergency Medical Center Tokyo Metropolitan Bokutoh Hospital  Sumida\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiro","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Tertiary Emergency Medical Center Tokyo Metropolitan Bokutoh Hospital  Sumida\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3581-0890","authenticated-orcid":false,"given":"Toru","family":"Hifumi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine St. Luke's International Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiko","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Hyogo Emergency Medical Center  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiro","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Department of Emergency, Disaster and Critical Care Medicine Kagawa University Hospital  Miki Kagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the SAVE\u2010J II Study 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