Conference Abstracts from COMET, April 2025 organized by SACTEM

Introduction:While systolic blood pressure has traditionally been the focus of hemodynamic monitoring, emerging evidence suggests that diastolic blood pressure (DBP) may play an equally, if not more important role in predicting outcomes.This is particularly relevant as coronary perfusion occurs primarily during diastole, and adequate diastolic pressure is essential for maintaining myocardial blood flow.Aims and Objectives: To evaluate the role of post-resuscitation diastolic blood pressure in predicting survival outcomes among cardiac arrest patients in a tertiary care hospital in Mangalore.Materials and Methods: This hospital-based retrospective study analyzed records of adult patients who achieved return of spontaneous circulation (ROSC) at KMC Hospital, Mangalore, between January 2020 and December 2022.The study population comprised all adult patients aged 18 years and above who achieved return of spontaneous circulation A structured data extraction sheet was developed based on the information available in the hospital records.The investigator personally visited the medical records department to collect the relevant data.Data regarding demographics, comorbidities, and vital parameters were collected.Information was systematically extracted from patient records and documented in the structured proforma.The data collection process focused on demographic details, clinical parameters, and particularly post-resuscitation diastolic blood pressure measurements and survival outcomes.Statistical analysis was performed using SPSS version 25. 0, with Chi-square test for associations and p < 0. 05 considered significant.Results: Among 99 patients studied, the mean age was 68.03 10. 9 years, with 55. 6% females.Common comorbidities included hypertension (67.7%) and ischemic heart disease (59.6%).The overall mortality rate was 65. 7%.Survivors demonstrated significantly higher mean diastolic blood pressure (85 18. 3 mm Hg) compared to non-survivors (62.7 22. 5 mm Hg, p < 0. 001).Similarly, systolic blood pressure was higher in survivors (128.5 31. 3 mm Hg vs 95 30.7 mm Hg, p < 0. 001).Heart rate also showed significant differences between survivors and non-survivors (102.8 28. 4 vs 72. 4 28. 3 bpm, p < 0. 001).Age, gender, and comorbidities showed no significant association with mortality.Discussion: The mean diastolic blood pressure among survivors (85 18. 3 mm Hg) was significantly higher than in non-survivors (62.7 22. 5 mm Hg, p < 0. 001).This finding strongly demonstrated that maintaining diastolic pressure above 65 mm Hg in the post-resuscitation period was associated with improved survival.DBP within 1 h demonstrated better outcome for survival to hospital discharge.In the absence of more sophisticated haemodynamic measures like pulmonary artery catheters or pulse contour cardiac output catheters, DBP can also be used as a stand-in indicator of systemic vascular resistance.Conclusion: Post-resuscitation diastolic blood pressure serves as a significant predictor of survival in cardiac arrest patients.The findings suggest that maintaining adequate diastolic blood pressure should be a key focus in post-resuscitation care protocols.Further prospective studies are warranted to establish optimal diastolic blood pressure targets.