This study aims to better understand how mechanical ventilation settings affect patients admitted to the coronary care unit after cardiac arrest or with cardiogenic shock. These patients often require mechanical ventilation, but current guidelines provide limited evidence on the best approach. Improper ventilation settings can lead to acid-base imbalances, such as respiratory acidosis or alkalosis, which may worsen patient outcomes.
The retrospective analysis will include 100 adult patients (50 post-cardiac arrest and 50 with cardiogenic shock) who were mechanically ventilated upon admission. The study has two main objectives:
Determine how often acid-base disorders occur in these patients and describe their characteristics.
Compare the initial ventilator settings chosen by clinicians with those suggested by VentilO, a decision-support algorithm.
The investigators will evaluate the potential effect of the VentilO recommendations on the first arterial (or capillary) blood gases compared to the real settings.
This information will help refine the algorithm and guide future research on improving ventilation strategies for critically ill cardiac patients.
Participation does not involve any intervention, as the study uses existing medical records.
Adult (Age >=18 years old)
Lack of patient anthropometric data (height and weight) available in the patient record
No information in the record regarding the data on the humidification systems used at the time of the first blood gas test upon admission to the coronary care unit.
Patient stabilzed in other hospital before coronary unit admission or adjustment of respiratory parameters after a blood gas test.
post cardiac arrest or cardiogenic shock
Cohort
Retrospective
Initiation of mechanical ventilation
Other interventionBlood gases evaluation after initiation of mechanical ventilation
Acid-base disorder (respiratory acidosis)
Presence of respiratory acisosis define by pH\< 7.35 and PaCO2 \> 45 mmHg
Acid-base disorder (respiratory alcalosis)
Presence of respiratory alcalosis define by by pH\>7.45 and PaCO2 \< 35 mmHg
Ventilator setting (Respiratory rate)
Respiratory rate set by the doctor, these setting will be compared to the suggestion of the algorithm
Ventilator setting (Tidal volume)
Tidal volume set by the doctor, these setting will be compared to the suggestion of the algorithm
Acid-base disorder (metabolic acidosis)
Presence of metabolic acidosis define by HCO3 \< 20 mmol/L
Acid-base disorder (metabolic alcalosis)
Presence of metabolic acidosis define by HCO3 \> 28 mmol/L
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