Abstract 10447: The Relationship Between Cerebral Regional Oxygen Saturation During Extracorporeal Cardiopulmonary Resuscitation and Neurological Outcome

Abstract

Introduction: In recent years, measurement of cerebral regional oxygen saturation (rSO2) has attracted attention during resuscitation. The objective of this study was to clarify the relationship between serial changes in cerebral rSO2 during extracorporeal cardiopulmonary resuscitation (ECPR) and neurological outcome. Hypothesis: Cerebral rSO2 during ECPR would predict neurological outcome. Methods: We measured serial changes in cerebral rSO2 in patients with out-of-hospital cardiac arrest before and after ECPR in Osaka National Hospital. Results: From January 2013 through March 2015, serial changes in cerebral rSO2 were evaluated in 16 patients. Their outcomes as measured by the Glasgow Outcome Scale (GOS) score at discharge included Good Recovery (GR) in 4 patients, Vegetative State (VS) in 2 patients, and Death (D) in 10 patients. In the poor neurological group (VS and D: n=12, 52.8±4.0 years), the values of cerebral rSO2 increased significantly with ECPR (5 min before ECPR: 52.0±1.8%; 2 min before: 56.1±2.3%; 2 min after ECPR: 63.5±2.2%; 5 min after: 66.4±2.2%; 10 min after: 67.6±2.3% [p<0.01]) (Figure). Contrastingly, in the good neurological group (GR: n=4, 53.8±6.9 years), the values of cerebral rSO2 did not increase significantly with ECPR (5 min before: 61.9±3.1%; 2 min before: 57.1±4.0%; 2 min after: 59.6±3.8%; 5 min after: 61.0±3.7%; 10 min after: 62.0±3.8% [p=0.88]) (Figure). Our study suggested that the patients who maintained a high value of cerebral rSO2 at admission and who did not have significant improvement of cerebral rSO2 after ECPR might have a good neurological prognosis. Conclusion: Cerebral rSO2 during ECPR could predict neurological outcome. Further evaluation of the validity of rSO2 monitoring during ECPR may lead to a new resuscitation strategy.