Cerebral Tissue Oxygenation Index Using Near-infrared Spectroscopy during Extracorporeal Cardio-pulmonary Resuscitation Predicted Good Neurological Recovery in a Patient with Acute Severe Anemia

Abstract

We herein report the clinical course of a patient who had a good neurological outcome despite severe anemia, high serum lactate levels, and a long period of time from cardiac arrest (CA) to extracorporeal cardio-pulmonary resuscitation (ECPR) establishment. During the period of resuscitation, the tissue oxygenation index (TOI) values were measured continuously by a near-infrared spectroscopy monitoring device and were kept within the normal range. The TOI seems to reflect cerebral perfusion and the balance between the oxygen supply and demand in the brain during ECPR, thereby predicting the neurological outcome. Continuous TOI monitoring is useful for predicting the neurological outcome during ECPR.

Cerebral oximetry: a developing tool for monitoring cerebral oxygenation during cardiopulmonary resuscitation

“…89 In another case, cerebral saturation rose acutely to 55% with the initiation of ECPR. 90 In one OHCA, rSO 2 increased from 30% under the effects of automated CPR to >75% after ECMO implementation. 91 These preliminary results suggest a substantial benefit of ECMO on cerebral oxygen delivery, which may improve survival and neurologic recovery even in patients refractory to conventional CPR.…”