Abstract 218: Cerebral Oximetry as a Post-ROSC Predictor of Neurologic Outcome After OOHCA

Abstract

No reliable early predictors of neurological outcome exist for patients resuscitated from an OOHCA. Objectives: We investigated the prognostic utility of cerebral oximetry (rSO2) obtained after Return of Spontaneous Circulation (ROSC) on neurological outcome after OOHCA. Methods: This IRB approved, observational trial collected data on a convenience sample of patients presenting to an academic, urban Emergency Department with OOHCA. Cerebral Oximetry uses near infrared spectroscopy to measure oxygen in the brain independent of pulse using adhesive rSO2sensors that were placed on patient’s forehead upon ED arrival and data recorded for at least 4 hours post ROSC. We followed Utstein criteria for demographics and data recording. Blinded investigators abstracted CPC scores for all patients. Outcome measure defined as good CPC (≤ 2) at hospital discharge. We analyzed data with descriptive statistics and logistic regression. Results: We analyzed 32 patients: 69% were male, mean age 62.5 years (52 to 75), 30 (93.8%) witnessed and 23 (71.9%) had bystander CPR. Initial rhythm was VF/VT 19%, PEA 40%, Asystole 34% and 2 unknown. There were 7 (22%) with good CPC at hospital discharge. Univariate analysis showed only the average rSO2 during first 4-hours post ROSC predictive of good outcome (p<0.003). Initial Mean Arterial Pressure (MAP) was a good prognosticator (p<0.087). Logistic regression revealed only average rSO2 4-hours post ROSC as indicative of good outcome (p<0.086). Conclusion: The average cerebral oximetry in the first 4 hours post ROSC was an excellent predictor of good neurological outcome at hospital discharge. This study is limited by small sample size and observational nature.