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. 2025 Aug 21:17:233-245.
doi: 10.2147/OAEM.S511715. eCollection 2025.

Respiratory Drive and Survival in Comatose Out-of-Hospital Post-Cardiac Arrest Patients

Purich Sintrirat  1 , Veerapong Vattanavanit  2
Affiliations

Respiratory Drive and Survival in Comatose Out-of-Hospital Post-Cardiac Arrest Patients

Purich Sintrirat et al. Open Access Emerg Med. .

Abstract

Purpose: This study aimed to explore alterations in respiratory drive in comatose patients after out-of-hospital cardiac arrest (OHCA) and their association with survival outcomes.

Patients and methods: A prospective cohort study was conducted on comatose patients with OHCA who were admitted between October 2022 and October 2024. Patients were followed until their discharge from the hospital and subsequently categorized into survivors and non-survivors. Respiratory drive was evaluated using P0.1, representing the airway occlusion pressure measured within the first 100 ms of inspiration, as displayed on the ventilator. Measurements were collected together with additional parameters at 24, 48, and 72 h following admission.

Results: The analysis involved 30 patients, with an in-hospital mortality rate of 53.3%. Over the 72-h observation period, P0.1 values were greater in survivors than in non-survivors; however, this difference was not statistically significant. During the first 24 h, survivors demonstrated significantly lower tidal volumes per predicted body weight (P = 0.034). P0.1 values ranging from 1.5 to 3.5 cmH2O in the initial 24 h were independently associated with reduced in-hospital mortality (adjusted OR 0.043, 95% CI 0.003-0.588, P = 0.018).

Conclusion: A trend toward elevated P0.1 levels in survivors was observed. P0.1 values within the range of 1.5-3.5 cmH2O during the first 24 h were linked to a lower mortality rate. These results indicate that P0.1 could be utilized as a prognostic indicator for comatose patients following OHCA.

Keywords: airway occlusion pressure; post-arrest; respiratory drive; survival; ventilation.

Plain language summary

This study explored how changes in respiratory drive relate to survival in unconscious patients after a cardiac arrest outside the hospital. Respiratory drive was assessed using P0.1, which measures the effort to take a breath, at 24, 48, and 72 hours after admission. The results showed that survivors tended to have higher P0.1 levels than non-survivors. Notably, patients with P0.1 values between 1.5 and 3.5 cmH2O in the first 24 hours were more likely to survive. These findings suggest that P0.1 could be a useful tool for predicting outcomes in critically ill patients.

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Conflict of interest statement

The authors declare that they have no competing interests in this work.

Figures

None
Graphical abstract
Figure 1
Figure 1
Patients enrolled in the study.
Figure 2
Figure 2
P0.1 trend in the survival and non-survival groups during the 72-h period post-admission.
Figure 3
Figure 3
P0.1 values for surviving patients (A) and non-surviving patients (B).
See this image and copyright information in PMC

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