Cerebral tissue oximetry levels during prehospital management of cardiac arrest – A prospective observational study

Prosen, Gregor; Strnad, Matej; Doniger, Stephanie J.; Markota, Andrej; Stožer, Andraž; Borovnik-Lesjak, Vesna; Mekiš, Dušan

doi:10.1016/j.resuscitation.2018.05.014

Cited by 39 publications

(51 citation statements)

References 17 publications

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“…The proportion of pre-hospital time with successful monitoring (>70%) was 71.4% (45 of 63) for all three sensors, with at least two sensors functional in 90.4% (57 of 63). The median (interquartile range) scene time was 19 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) minutes in patients with NIRS monitoring compared to 18 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) minutes without NIRS monitoring (P = .570). There was no difference in the median (interquartile range) total pre-hospital time between patients with or without monitoring sensors (72 [59-89] versus 72 [59-80] minutes; P = .605).…”

Section: Resultsmentioning

confidence: 98%

“…For time spent at the scene, there was no difference between the three patient groups (Table 1); patients with or without NIRS monitoring also had similar scene times (P = .570). In the sensitivity analysis, the median (IQR) scene time for those with sensors applied who met the inclusion criteria (n = 53) was 19 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) with no difference between patients with and without NIRS monitoring (P = .867). For total pre-hospital time, there was no difference between the three patient groups (Table 1); patients with or without NIRS monitoring also had similar total pre-hospital time (P = .605).…”

Section: Re Sultsmentioning

confidence: 99%

“…18 Coupled with feasibility evidence in out-of-hospital cardiac arrest management, the promise of NIRS oximetry is still evident, though these reports have not focussed as extensively on the proportion of successful monitoring and often rely on a single NIRS sensor. [19][20][21] With extracranial contamination and ambient light in an operating theatre environment previously highlighted as potential issues, the demonstration that outdoor ambient light does not preclude monitoring is reassuring. 22,23 The goal of NIRS monitoring should be to provide information that responds accurately enough to evolving changes in physiology to allow clinicians to make meaningful changes to their care and produce better patient outcomes.…”

Section: Feasibility Of Nirs Oximetry For Clinical Application In Tmentioning

confidence: 99%

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Near‐infrared spectroscopy monitoring in a pre‐hospital trauma patient cohort: An analysis of successful signal collection

Weatherall

Poynter²,

Garner³

et al. 2019

Acta Anaesthesiol Scand

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A primary aim of managing critically injured patients is the maintenance of perfusion to vital organs, particularly the brain.Discussion of traumatic brain injury (TBI) management frequently focuses on hospital care but the pre-hospital phase, even in urban areas of Australia, is often more than one hour. Delivery of nutrients to the brain is no less vital during this period than during the hospital admission to prevent the deleterious effects of secondary brain injury.TBI is a significant cause of morbidity and mortality with younger age groups most commonly affected. In TBI survivors, almost 50% have permanent deficits causing at least moderate disability. 1 Such disability can be present in up to 43% of patients up to 20 years after their injury. 1 With estimates that patients suffering TBI add $8.6 billion per year to the costs of health care in Australia, there is a clear rationale for pursuing optimal TBI management. 2

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Section: Resultsmentioning

confidence: 98%

Section: Re Sultsmentioning

confidence: 99%

Section: Feasibility Of Nirs Oximetry For Clinical Application In Tmentioning

confidence: 99%

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Near‐infrared spectroscopy monitoring in a pre‐hospital trauma patient cohort: An analysis of successful signal collection

Weatherall

Poynter²,

Garner³

et al. 2019

Acta Anaesthesiol Scand

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“…Furthermore, OHCA is associated with increased levels of morbidity and mortality worldwide and the majority of patients who attain ROSC often exhibit poorer neurologic outcomes, compared with those who experience in-hospital cardiac arrest (17). Therefore, it was hypothesized that it might be useful to evaluate the values and dynamics of continuous S ct O 2 measurements during OHCA, particularly around the time of ROSC (18).…”

Section: Discussionmentioning

confidence: 99%

Effects of therapeutic hypothermia on cerebral tissue oxygen saturation in a swine model of post‑cardiac arrest

Jin

et al. 2019

Exp Ther Med

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Since the introduction of therapeutic hypothermia (TH), trends have changed in the monitoring indicators used during and after cardiac arrest. During hypothermia, the cerebral metabolic rate of oxygen is reduced, which leads to uncertainty in regional cerebral tissue oxygen saturation (S ct O 2). The aim of the present study was to evaluate the effect of TH on changes in S ct O 2 using near-infrared spectroscopy. A total of 23 male domestic pigs were randomized into three groups: TH (n=9), normothermia (NT; n=9) and control (n=5). Animals in the control group underwent surgical preparation only. The animal models were established using 8 min of ventricular fibrillation and 5 min of cardiopulmonary resuscitation. In the TH group, at 5 min after resuscitation, the animals were cooled with a cooling blanket and ice packs for 24 h. S ct O 2 was recorded throughout the experiment. In all groups, The mean arterial pressure, arterial carbon dioxide partial pressure, arterial oxygen partial pressure, lactate, neuron-specific enolase (NSE) and S100B were measured at baseline and at 1, 3, 6, 12, 24 and 30 h after resuscitation. S ct O 2 significantly decreased after ventricular fibrillation, compared with the baseline. Following resuscitation, the S ct O 2 values gradually increased to 55.6±3.8% of baseline in the TH group and 51.2±3.5% in the NT group (P=0.039). Significant differences between the two groups were observed, starting at 6 h after cardiac arrest. Throughout the hypothermic period, NSE and S100B showed an increasing trend, then decreased during rewarming in the TH and NT groups. NSE and S100B showed greater improvement in the TH group compared with the NT group at 6 and 24 h after resuscitation. Following cardiac arrest, therapeutic hypothermia could increase S ct O 2 after resuscitation and could improve neurological outcome. In conclusion, S ct O 2 may be a feasible marker for use in the early assessment of brain damage during and after cardiac arrest.

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“…Among 183 in-hospital CA (IHCA) patients [3] As has been observed for end-tidal carbon dioxide (ETCO 2 ), an abrupt increase in rSO 2 values during CPR indicates that ROSC has occurred [5]. In a study on 53 OHCA patients, 22 (42%) had ROSC after a mean of 22.5 min of CPR; when ROSC occurred, the median rSO 2 increased from 22.5% [16-35] to 51% [39-55] in 3 min [6]. A potential advantage of rSO 2 compared with ETCO 2 for monitoring during CPR is that detection of the rSO 2 signal does not require advanced airway management.…”

Section: Use Of Cerebral Oximetry During Cardiac Arrestmentioning

confidence: 99%

Cerebral oximetry in cardiac arrest: a potential role but with limitations

2019

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Cerebral tissue oximetry levels during prehospital management of cardiac arrest – A prospective observational study

Cited by 39 publications

References 17 publications

Near‐infrared spectroscopy monitoring in a pre‐hospital trauma patient cohort: An analysis of successful signal collection

Near‐infrared spectroscopy monitoring in a pre‐hospital trauma patient cohort: An analysis of successful signal collection

Effects of therapeutic hypothermia on cerebral tissue oxygen saturation in a swine model of post‑cardiac arrest

Cerebral oximetry in cardiac arrest: a potential role but with limitations

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