This observational study evaluated whether event-average SpO2 during out-of-hospital cardiac arrest (OHCA) resuscitation was associated with sustained ROSC, survival to hospital admission, and neurological intact survival in 98 adult OHCA patients.
Higher event-average SpO2 was independently associated with sustained ROSC (aOR 1.05 per unit, 95% CI 1.02–1.08; P<0.001) and survival to hospital admission (aOR 1.03, 95% CI 1.01–1.05; P=0.005), but not with neurological intact survival (aOR 1.00; P=0.79). ROC analysis identified an optimal SpO2 cut-point of 71.0 (AUC 0.77; sensitivity 58%, specificity 85%).
- Very small sample (n=98) with only 9.2% shockable rhythms, limiting generalizability. - Observational design cannot establish causation; SpO2 may be a marker of resuscitation success rather than a modifiable driver. - No association found with neurological intact survival, the most clinically meaningful outcome.
During OHCA resuscitation, an event-average SpO2 ≥71% may help identify patients more likely to achieve ROSC, but it does not predict neurological intact survival. Clinicians should interpret pulsed SpO2 during CPR cautiously, as its value as a real-time quality metric remains unproven.
