Portable system for monitoring of regional cerebral oxygen saturation during prehospital cardiopulmonary resuscitation: a pilot study

Tajima, Goro; Shiozaki, Tadahiko; Izumino, Hiroo; Yamano, Shuhei; Hirao, Tomohito; Inokuma, Takamitsu; Yamashita, Kazunori; Nagatani, Atsuko; Onishi, Mitsuo; Hirose, Tomoya; Shimazu, Takeshi; Hamasaki, Toshimitsu; Tasaki, Osamu

doi:10.1002/ams2.71

Cited by 6 publications

(10 citation statements)

References 14 publications

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“…Both Ito et al [ 5 ] and Storm et al [ 11 ] revealed significantly higher cerebral rSO 2 values on hospital arrival in patients with a good neurological outcome, but the cerebral rSO 2 values of the good and poor outcome groups varied widely and there was a large amount of overlap. We hypothesised that a single measurement of cerebral value might not be important because the rSO 2 values always change depending on the patient’s situation at the time of the rSO 2 measurement [ 4 , 8 ]. Therefore, we think that the value of NIRS should be assessed by trend value, not by absolute value.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, we developed a portable rSO 2 monitor (HAND ai TOS®; TOSTEC Co.), which is 170 × 100 × 50 mm in size and 600 g in weight and which is small enough to carry in the pre-hospital settings. Thus, we can now measure the pre-hospital rSO 2 values [ 8 ]. There is a need for a prospective multi-centre study that includes measurements from the pre-hospital setting.…”

Section: Discussionmentioning

confidence: 99%

“…Although some researchers have reported that the cerebral rSO 2 value at hospital arrival can predict the neurological outcome in patients with OHCA [ 5 – 7 ], we thought that this conclusion was incorrect. Because the rSO 2 values always change depending on the patient’s situation at the time when the cerebral rSO 2 is measured [ 4 , 8 ], we hypothesise that the serial change in the rSO 2 values is important rather than a single measured value.…”

Section: Introductionmentioning

confidence: 99%

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The relationship between cerebral regional oxygen saturation during extracorporeal cardiopulmonary resuscitation and the neurological outcome in a retrospective analysis of 16 cases

et al. 2017

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BackgroundIn recent years, the measurement of cerebral regional oxygen saturation (rSO2) during resuscitation has attracted attention. The objective of this study was to clarify the relationship between the serial changes in the cerebral rSO2 values during extracorporeal cardiopulmonary resuscitation (ECPR) and the neurological outcome.MethodsWe measured the serial changes in the cerebral rSO2 values of patients with out-of-hospital cardiac arrest before and after ECPR in Osaka National Hospital.ResultsFrom January 2013 through March 2015, the serial changes in the cerebral rSO2 values were evaluated in 16 patients. Their outcomes, as measured by the Glasgow Outcome Scale (GOS) score at discharge, included good recovery (GR) (n = 4), vegetative state (VS) (n = 2), and death (D) (n = 10). In the poor neurological group (VS and D: n = 12; age, 52.8 ± 4.0 years), the cerebral rSO2 values showed a significant increase during ECPR (5 min before ECPR: 52.0 ± 1.8%; 2 min before ECPR: 56.1 ± 2.3%; 2 min after ECPR: 63.5 ± 2.2%; 5 min after ECPR: 66.4 ± 2.2%; 10 min after ECPR: 67.6 ± 2.3% [P < 0.01]). In contrast, in the good neurological group (GR: n = 4; age, 53.8 ± 6.9 years), the cerebral rSO2 values did not increase to a significant extent during ECPR (5 min before ECPR: 61.9 ± 3.1%; 2 min before ECPR: 57.1 ± 4.0%; 2 min after ECPR: 59.6 ± 3.8%; 5 min after ECPR: 61.0 ± 3.7%; 10 min after ECPR: 62.0 ± 3.8% [P = 0.88]). Our study suggested that the patients whose cerebral rSO2 values showed no significant improvement after ECPR might have had a good neurological prognosis.ConclusionsThe serial changes in the cerebral rSO2 values during ECPR may predict a patient’s neurological outcome. The further evaluation of the validity of rSO2 monitoring during ECPR may lead to a new resuscitation strategy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The relationship between cerebral regional oxygen saturation during extracorporeal cardiopulmonary resuscitation and the neurological outcome in a retrospective analysis of 16 cases

et al. 2017

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“…We think that LDB-CPR may offer a significant beneficial effect on the maintenance of cerebral oxygenation during resuscitation. Moreover, we have developed a portable NIRS system and conducted a pilot study of the device [ 16 ]. This will allow us to evaluate changes in rSO 2 resulting from prehospital mechanical chest compression.…”

Section: Discussionmentioning

confidence: 99%

Load-distributing-band cardiopulmonary resuscitation for out-of-hospital cardiac arrest increases regional cerebral oxygenation: a single-center prospective pilot study

Ogawa

Shiozaki

Hirose

et al. 2015

Scand J Trauma Resusc Emerg Med

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BackgroundDespite advances in therapeutic strategies and improved guidelines, morbidity and mortality rates for out-of-hospital cardiac arrest (OHCA) remain high. Especially, neurological prognosis is one of the most important problems even though brain protection therapy for patients with OHCA has improved greatly in recent years due to the development of emergency post-cardiac arrest interventions such as mild therapeutic hypothermia, early percutaneous coronary intervention, and extracorporeal cardiopulmonary resuscitation (CPR). Recently, cerebral regional oxygen saturation (rSO2) has received attention as a method for evaluation of cerebral oxygenation. We have reported that conventional chest compression did not improve the rSO2 of cardiac arrest patients if they did not achieve return of spontaneous circulation. It is, however, unclear whether a mechanical CPR device is helpful in improving rSO2. The purpose of this study was to evaluate the effects of load-distributing-band CPR (LDB-CPR) on rSO2.MethodsIn this prospective study, LDB-CPR was begun for OHCA with the AutoPulseTM device on patient arrival at hospital. During mechanical CPR, rSO2 values were recorded continuously from the forehead of the patients. CPR for patients with OHCA was performed according to the Japan Resuscitation Council Guidelines 2010 except for using the AutoPulseTM instead of manual chest compression.ResultsFrom December 2012 to December 2013, 34 patients (mean age, 75.6 ± 12.8 years) with OHCA were included in this study. Duration of time from recognition of cardiac collapse to arrival to hospital was 31.0 ± 11.4 min. Compared with the rSO2 value of 38.9 ± 0.7 % prior to starting LDB-CPR, rSO2 values at 4, 8 and 12 minutes increased significantly after initiation of LDB-CPR (44.0 ± 0.9 %, 45.2 ± 0.8 %, and 45.5 ± 0.8 %, respectively, p < 0.05).ConclusionLDB-CPR significantly increased the rSO2 of cardiac arrest patients during resuscitation.

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“…[2][3][4][5][6] Our group has reported the effect of cerebral rSO 2 monitoring in patients with out-of-hospital cardiac arrest (OHCA) in resuscitation situations for several years. [6][7][8][9][10] In addition to cerebral rSO 2 , we have also recorded the hemoglobin index (HbI). The HbI is the amount of hemoglobin measured by near-infrared radiation and is determined by the measurement of light intensity received at 805 nm.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of the hemoglobin index for screening of subarachnoid hemorrhage in out‐of‐hospital cardiopulmonary arrest patients: a retrospective observational study

Mori

Hirose

Shiozaki

et al. 2019

Acute Medicine & Surgery

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The hemoglobin index (HbI) represents the amount of hemoglobin, which reflects regional tissue blood volume. The HbI is calculated in real time by a regional oxygen saturation (rSO 2) monitor. For the hypothesis of our HbI project, we theorized that HbI could be a new method for the screening of subarachnoid hemorrhage (SAH) in overcrowded emergency departments. As a first step, this study aimed to clarify the effectiveness of HbI in screening SAH in out-of-hospital cardiopulmonary arrest (OHCA) patients using the rSO 2 data of our previous studies. Methods: In this single-center, retrospective, observational study, we examined HbI in patients with OHCA transferred to the Trauma and Acute Critical Care Center at Osaka University Hospital (Osaka, Japan) during the period between April 2013 and December 2015. A sensor attached to the patient's forehead monitored HbI continuously. Results: Among 63 patients (40 men and 23 women; mean age, 76 [interquartile range (IQR), 66-85] years) with OHCA, five were diagnosed as having SAH (SAH group) and 58 were not (non-SAH group). The HbI values were significantly higher in the SAH group than in the non-SAH group (1.35 [IQR: 0.80-2.69] versus 0.41 [IQR: 0.32-0.61]), P = 0.0042). In the SAH group, with an HbI cutoff value of 1.18, the specificity and sensitivity were 96% and 80%, respectively, and the area under the receiver operating characteristic curve of HbI was 0.89. Conclusions: The HbI might be useful for the screening of SAH in patients with OHCA. The application of HbI in the emergency department could be expected in the future.

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Portable system for monitoring of regional cerebral oxygen saturation during prehospital cardiopulmonary resuscitation: a pilot study

Cited by 6 publications

References 14 publications

The relationship between cerebral regional oxygen saturation during extracorporeal cardiopulmonary resuscitation and the neurological outcome in a retrospective analysis of 16 cases

The relationship between cerebral regional oxygen saturation during extracorporeal cardiopulmonary resuscitation and the neurological outcome in a retrospective analysis of 16 cases

Load-distributing-band cardiopulmonary resuscitation for out-of-hospital cardiac arrest increases regional cerebral oxygenation: a single-center prospective pilot study

Effectiveness of the hemoglobin index for screening of subarachnoid hemorrhage in out‐of‐hospital cardiopulmonary arrest patients: a retrospective observational study

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