Abstract 237: Cerebral and Somatic rSo2 Monitoring During Pediatric Cardiopulmonary Resuscitation

Abstract

Pediatric resuscitation/arrest has no assessment for tissue resuscitative efforts. Patients have inadequate tissue perfusion despite adequate systemic perfusion during resuscitation. Traditional methods for effective resuscitation have inherent flaws and don’t assess tissue resuscitation. Resuscitated patients by global methods, have significant tissue hypoxia. Refinement in goal directed therapy is to detect tissue resuscitation effects. During resuscitation, better endpoints are needed to guide resuscitation and endpoints. Near-infrared spectroscopy (NIRS) permits noninvasive readings of cerebral and somatic rSO2 tissue saturation. NIRS in adult resuscitations is predictor for survival and neurological outcome. A 15% rSO2 means no detectable tissue O2Hgb. A 95% rSO2 is interpreted as increased perfusion with no tissue O2 extraction. Purpose: Retrospective analysis of Pediatric ED (PED) Resuscitation/CPR cases with cerebral & somatic rSO2 monitoring. Methods: 1/09- 2/12 PED patients with resuscitation/CPR had noninvasive monitoring with cerebral & somatic rSO2 monitoring. Probes were placed on left & right forehead & right deltoid. Recordings were every 30 seconds. Medical records and autopsy were reviewed. Results: Twenty nine patients were monitored Age 9 wks -16 yrs with 75% males. All patients expired. Patient’s etiology were Trauma or Medical: Sepsis, SUID, Drowning, Ingestion. Conclusion: Preliminary data shows unique Cerebral & Somatic rSO2 monitoring in pediatric resuscitation and CPR. As in adult studies, cerebral and somatic rSO2 for our patients showed similar rSO2 of 95% and 15%. Small sample size precludes definitive conclusions. Our observations shows cerebral and somatic rSO2 gives real-time information on tissue oxygenation during pediatric resuscitations. A large validation study using cerebral and somatic rSO2 with global monitoring is warranted.