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Purpose: Metabolic acidosis is observed in 98% of patients with out-of-hospital cardiac arrest (OHCA). The longer the no-flow or low-flow duration, the more severe the acidosis is. This study aim to demonstrate the blood pH on arrival at emergency department (ED) could be a predictor of neurological prognosis in patients with OHCA.

Methods: We retrospectively recruited patients with OHCA and blood gas analyses performed upon arrival at the ED from January 2012 to June 2017. Those aged younger than 20 years, cardiac arrest consecutive to trauma, and those with do-not-resuscitate orders were excluded. Patient's data were collected according to the Utstein-style template. The primary outcome was neurological status at hospital discharge.

Results: A total of 1711 patients with OHCA were enrolled. OHCA was witnessed in 458 cases, and 207 (12.1%) patients had a shockable rhythm. 54 (3.16%) patients …