Serum potassium concentration predicts brain hypoxia on CT after avalanche-induced cardiac arrest

Brain anoxia after complete avalanche burial and cardiac arrest (CA) may occur despite adequate on-site triage. To investigate clinical and biological parameters associated with brain hypoxia in a cohort of avalanche victims with whole body computed tomographic (CT) scan. Retrospective study of pati...

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Bibliographic Details
Published in:The American journal of emergency medicine 2016-05, Vol.34 (5), p.856-860
Main Authors: Cohen, Julien G., Boué, Yvonnick, Boussat, Bastien, Reymond, Emilie, Grand, Sylvie, Blancher, Marc, Ferretti, Gilbert R., Bouzat, Pierre
Format: Article
Language:English
Subjects:
Abdomen
Adult
Airway management
Algorithms
Anoxia
Asphyxia - blood
Asphyxia - complications
Avalanches
Biomarkers - blood
Brain
Cardiac arrest
Computed tomography
Coronary vessels
Edema
Emergency medical care
Female
Heart Arrest - blood
Heart Arrest - etiology
Humans
Hypothermia
Hypoxia
Hypoxia, Brain - blood
Hypoxia, Brain - diagnostic imaging
Hypoxia, Brain - etiology
Injuries
Life Sciences
Male
Medical imaging
Medical prognosis
Mortality
Potassium
Potassium - blood
Predictive Value of Tests
Retrospective Studies
Snow
Tomography, X-Ray Computed
Vertebrae
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Summary:Brain anoxia after complete avalanche burial and cardiac arrest (CA) may occur despite adequate on-site triage. To investigate clinical and biological parameters associated with brain hypoxia in a cohort of avalanche victims with whole body computed tomographic (CT) scan. Retrospective study of patients with CA and whole body CT scan following complete avalanche burial admitted in a level-I trauma center. Out of 19 buried patients with whole body CT scan, eight patients had refractory CA and 11 patients had pre-hospital return of spontaneous circulation. Six patients survived at hospital discharge and only two had good neurologic outcome. Twelve patients had signs of brain hypoxia on initial CT scan, defined as brain edema, loss of gray/white matter differentiation and/or hypodensity of basal ganglia. No clinical pre-hospital parameter was associated with brain anoxia. Serum potassium concentration at admission was higher in patients with brain anoxia as compared to patients with normal CT scan: 5.5 (4.1–7.2) mmol/L versus 3.3 (3.0–4.2) mmol/L, respectively (P
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2016.01.037