A pilot study examining the role of regional cerebral oxygen saturation monitoring as a marker of return of spontaneous circulation in shockable (VF/VT) and non-shockable (PEA/Asystole) causes of cardiac arrest

Ahn, Anna; Nasir, Asad; Malik, Hanan; Dorazi, Francis; Parnia, Sam

doi:10.1016/j.resuscitation.2013.07.026

Cited by 76 publications

(73 citation statements)

References 16 publications

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“…However, hypoxemia was induced by application of artificial gas-mixtures simulating high altitude hypoxia. Investigations were performed for up to 4 h studying long term changes in rSO 2 and SpO 2 follows hypoxia [37]. Such a time-course is not representative for acute respiratory emergency situations and to the best of our knowledge investigations on cerebral rSO 2 and SpO 2 during acute hypoxemia in the presence of hypercapnia were still missing.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of near-infrared spectroscopy under apnea-dependent hypoxia in humans

Eichhorn

Erdfelder

Kessler

et al. 2015

J Clin Monit Comput

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In this study we investigated the responsiveness of near-infrared spectroscopy (NIRS) recordings measuring regional cerebral tissue oxygenation (rSO2) during hypoxia in apneic divers. The goal was to mimic dynamic hypoxia as present during cardiopulmonary resuscitation, laryngospasm, airway obstruction, or the "cannot ventilate cannot intubate" situation. Ten experienced apneic divers performed maximal breath hold maneuvers under dry conditions. SpO2 was measured by Masimo™ pulse oximetry on the forefinger of the left hand. NIRS was measured by NONIN Medical's EQUANOX™ on the forehead or above the musculus quadriceps femoris. Following apnea median cerebral rSO2 and SpO2 values decreased significantly from 71 to 54 and from 100 to 65%, respectively. As soon as cerebral rSO2 and SpO2 values decreased monotonically the correlation between normalized cerebral rSO2 and SpO2 values was highly significant (Pearson correlation coefficient = 0.893). Prior to correlation analyses, the values were normalized by dividing them by the individual means of stable pre-apneic measurements. Cerebral rSO2 measured re-saturation after termination of apnea significantly earlier (10 s, SD = 3.6 s) compared to SpO2 monitoring (21 s, SD = 4.4 s) [t(9) = 7.703, p < 0.001, r(2) = 0.868]. Our data demonstrate that NIRS monitoring reliably measures dynamic changes in cerebral tissue oxygen saturation, and identifies successful re-saturation faster than SpO2. Measuring cerebral rSO2 may prove beneficial in case of respiratory emergencies and during pulseless situations where SpO2 monitoring is impossible.

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Section: Discussionmentioning

confidence: 99%

Evaluation of near-infrared spectroscopy under apnea-dependent hypoxia in humans

Eichhorn

Erdfelder

Kessler

et al. 2015

J Clin Monit Comput

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“…Determination of both cerebral and abdominal saturations simultaneously renders our study superior to that of Ahn et al [7]. Because there was a good correlation between cerebral and abdominal oxygenations, elevation of abdominal saturation is also a good indicator of ROSC.…”

Section: Discussionmentioning

confidence: 50%

“…Most studies, in which cerebral oxygenation was monitored by NIRS during CPR, show that an increase in the low values measured at the onset of resuscitation is positively correlated with the ROSC [4,21]. Ahn et al [7] measured cerebral oxygenation in their patients with out-of-hospital CA during CPR. Return of spontaneous circulation was observed in patients with increasing ScO 2 levels over the initial values [7].…”

Section: Discussionmentioning

confidence: 99%

“…Ahn et al [7] measured cerebral oxygenation in their patients with out-of-hospital CA during CPR. Return of spontaneous circulation was observed in patients with increasing ScO 2 levels over the initial values [7].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have recently been performed on the practicability of nearinfrared spectrophotometry (NIRS) for assessing oxygenation of vital organs such as the brain after cardiac arrest (CA) [1][2][3][4][5][6][7][8]. The majority of these have suggested that cardiopulmonary resuscitation (CPR) affects elevated cerebral saturation during resuscitation and can be used to predict ROSC.…”

Section: Introductionmentioning

confidence: 99%

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Abdominal oxygen saturation for monitoring return of spontaneous circulation in out-of-hospital cardiac arrest using near infrared spectrophometry

Kalkan¹,

Bilir²,

Ersunan³

et al. 2015

The American Journal of Emergency Medicine

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Cerebral oxygenation monitoring during resuscitation by emergency medical technicians: a prospective multicenter observational study

Hamanaka

Shimoto

Hitosugi

et al. 2020

Acute Medicine & Surgery

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To assess the feasibility and predictive ability of regional cerebral oxygen saturation monitoring during cardiopulmonary resuscitation by emergency medical technicians. Methods: This prospective observational study included 33 cardiac arrest patients who received cardiopulmonary resuscitation in a prehospital setting. Patients were connected to a near-infrared spectrometer through two disposable probes immediately after entering the ambulance. The monitor, which showed regional cerebral oxygen saturation readings, was obscured by covering it with a sheet of paper. Regional cerebral oxygen saturation was measured continuously until hospital arrival. Outcome variables included the prehospital return of spontaneous circulation, survival to hospital admission, and survival at 90 days. Results: For patients who survived >90 days after hospital admission (n = 2), the mean regional cerebral oxygen saturation values upon ambulance and hospital arrival were 24% and 60%, respectively; for patients who did not survive (n = 31), the mean regional cerebral oxygen saturation values were 15% and 17%, respectively. Regional cerebral oxygen saturation values increased to a greater extent between ambulance arrival and hospital arrival in patients who survived >90 days (median, 36%; interquartile range, 32-40%) than in those who did not survive (0; 0-6%; P = 0.07). Additionally, regional cerebral oxygen saturation values were not related to the prehospital return of spontaneous circulation or survival to hospital admission. Conclusion: Regional cerebral oxygen saturation could be monitored during resuscitation by emergency medical technicians, and it can be used during physiological monitor-guided cardiopulmonary resuscitation.

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A pilot study examining the role of regional cerebral oxygen saturation monitoring as a marker of return of spontaneous circulation in shockable (VF/VT) and non-shockable (PEA/Asystole) causes of cardiac arrest

Cited by 76 publications

References 16 publications

Evaluation of near-infrared spectroscopy under apnea-dependent hypoxia in humans

Evaluation of near-infrared spectroscopy under apnea-dependent hypoxia in humans

Abdominal oxygen saturation for monitoring return of spontaneous circulation in out-of-hospital cardiac arrest using near infrared spectrophometry

Cerebral oxygenation monitoring during resuscitation by emergency medical technicians: a prospective multicenter observational study

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