Turkish Journal of Anaesthesiology & Reanimation

Pupil Reactivity in Refractory Out-ofHospital Cardiac Arrest Treated by ExtraCorporeal Cardiopulmonary Resuscitation


Intensive Care Unit, Anaesthesiology department and SAMU of Paris, Hospital Necker, Assistance Publique Hôpitaux de Paris, Paris Descartes University, Paris, France

Turk J Anaesthesiol Reanim 2020; 48: 294-299
DOI: 10.5152/TJAR.2019.75418
Read: 145 Downloads: 63 Published: 18 December 2019

Objective: The objective of this study was to assess the association of early pupil evaluation with death occurrence on Day 28 in patients with refractory out-of-hospital cardiac arrest (ROHCA) admitted to the intensive care unit (ICU) and treated by extra-corporeal cardiopulmonary resuscitation (eCPR).


Methods: The pupil size (miosis, intermediary or mydriasis) and bilateral pupillary light reactivity (present or absent) were monitored in sedated and paralysed patients treated by eCPR. Mortality was assessed on Day 28.


Results: A total of 46 consecutive patients with ROHCA were included in the study. Thirty (65%) patients died on Day 28. Twenty-seven (90%) patients had pupils non-reactive to light, and 18 (60%) had mydriasis at the ICU admission. Using logistic regression, including age, gender, no flow, low-flow, size and pupil reactivity to light, only the pupillary reactivity to light remained associated with death on Day 28 (Odds ratio=0.12, 95%CI=[0.01-0.96]).


Conclusion: Pupils not reacting to light at the ICU admission were associated with mortality on Day 28 in patients with ROHCA. Pupillary light reactivity is a simple and easy tool that can be used to early detect a poor outcome in patients with ROHCA treated by eCPR.


Cite this article as: Jouffroy R, Saade A, Philippe P, Guyard A, Carli P, Vivien B. Pupil Reactivity in Refractory Out-of-Hospital Cardiac Arrest Treated by Extra-Corporeal Cardiopulmonary Resuscitation. Turk J Anaesthesiol Reanim 2020; 48(4): 294-9.

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