The significance of albumin corrected anion gap in patients with cardiopulmonary arrest.

PURPOSE: The reliable parameter, which can be obtained easily and quickly, is necessary to predict the return of spontaneous circulation (ROSC) of patients with cardiopulmonary arrest (CPA) in the emergency situation. In this study, we evaluated the significance of albumin corrected anion gap (ACAG) for the prediction of ROSC in patients with CPA.

PATIENTS AND METHODS: In 166 patients with CPA between January 2009 and December 2010, 132 patients could be analyzed retrospectively. We compared acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment(SOFA) score, anion gap (AG) and ACAG levels between patients with/without ROSC and evaluated the significance of AG and ACAG to predict ROSC in patients with CPA.

RESULTS: Both AG and ACAG were significantly lower in patients with ROSC than in patients without ROSC. Both AG and ACAG had the relation with APACHE II and SOFA scores, however, coefficients of correlation with APACHE II and SOFA score were higher in ACAG (r = 0.506) than in AG (r = 0.482). The sensitivity, specificity, positive predictive value, and negative predictive value of ACAG for the prediction of ROSC in patients with CPA were better than those of AG.

CONCLUSION: Our study shows that both AG and ACAG have the relation with ROSC and ACAG is better to predict the ROSC following CPR in patients with CPA compared with AG. ACAG can be easily obtained in the emergency situation, and ACAG is a useful parameter to predict ROSC in patients with CPA.