Abstract
Introduction: Simplified monitoring system of regional cerebral oxygen saturation (rSO 2 ) is a non-invasive technology for cerebral perfusion, but continuous changes of cerebral rSO 2 values among OHCA patients in pre-hospital settings have been insufficiently investigated. Methods: We recently developed a portable rSO 2 monitoring system that is very small (170х100х50mm in size and 600g in weight) and can use in pre-hospital settings. The sensor pad is attached to the patient’s forehead by the emergency-medical-service (EMS) personnel, and it can monitor cerebral rSO 2 immediately and continuously during CPR, from June 2013 through May 2018 in Osaka City, Japan. Results: We collected continuous changes in cerebral rSO 2 values for 72 OHCA patients during CPR by EMS personnel. Sixty-six cases were measured rSO 2 before ROSC and 6 cases were measured after ROSC. According to the analyses of continuous changes in rSO 2 values of 66 cases, two patterns of changes in cerebral rSO 2 values were found as follows; Type 1: Increasing rSO 2 type (n=30). Measured rSO 2 increased gradually during CPR or after ROSC. Type 2: Not increasing rSO 2 type (n=36) Measured rSO 2 did not increase during CPR. And we found out two phenomena of changes in cerebral rSO 2 values were found as follows; Phenomenon 1: Dropping rSO 2 type (n=3). Measured rSO 2 dropped after confirmation of ROSC or before arrest, which suggests that the re-arrest or arrest occurred during monitoring. Phenomenon 2: Initially decreasing rSO 2 type (n=6). Measured rSO 2 decreased gradually despite performing CPR by EMS personnel, which suggests that short time has passed after arrest. Conclusion: We measured continuous changes in cerebral rSO 2 values among 72 patients with OHCA pre-hospital settings and found the 2 patterns and 2-specific phenomena regarding continuous changes in rSO 2 values. Furthermore, it is needed to collect many cases to establish resuscitation strategies for OHCA by using cerebral rSO 2 monitoring.
Published Version
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