Abstract
BackgroundIn recent years, measurement of cerebral regional oxygen saturation (rSO2) has attracted attention during resuscitation. However, serial changes of cerebral rSO2 in pre-hospital settings are unclear. The objective of this study was to clarify serial changes in cerebral rSO2 of patients with out-of-hospital cardiac arrest (OHCA) in the pre-hospital setting.MethodsWe recently developed a portable rSO2 monitor that is small (170 × 100 × 50 mm in size and 600 g in weight) enough to carry in pre-hospital settings. The sensor is attached to the patient’s forehead by the ELT (Emergency Life-saving Technician), and it monitors rSO2 continuously.ResultsFrom June 2013 through August 2014, serial changes in cerebral rSO2 in seven patients were evaluated. According to the results of the serial changes in rSO2, four patterns of rSO2 change were found, as follows. Type 1: High rSO2 (around about 60 %) type (n = 1). Initial electrocardiogram was ventricular fibrillation and ROSC (return of spontaneous circulation) could be diagnosed in pre-hospital setting. Her outcome at discharge was Good Recovery (GR). Type 2: Low rSO2 (around about 45–50 %) type (n = 3). They did not get ROSC even once. Type 3: Gradually decreasing rSO2 type (n = 2): ROSC could be diagnosed in hospital, but not in pre-hospital setting. Their outcomes at discharge were not GR. Type 4: other type (n = 1). In this patient with ROSC when ELT started cerebral rSO2 measurement, cerebral rSO2 was 67.3 % at measurement start, it dropped gradually to 54.5 %, and then rose to 74.3 %. The cerebral oxygenation was impaired due to possible cardiac arrest again, and after that, ROSC led to the recovery of cerebral blood flow.ConclusionWe could measure serial changes in cerebral rSO2 in seven patients with OHCA in the pre-hospital setting. Our data suggest that pre-hospital monitoring of cerebral rSO2 might lead to a new resuscitation strategy.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2239-4) contains supplementary material, which is available to authorized users.
Highlights
In recent years, measurement of cerebral regional oxygen saturation has attracted attention during resuscitation
Some research groups have reported that cerebral regional oxygen saturation (rSO2) on hospital arrival can predict neurological outcome in patients with out-of-hospital cardiac arrest (OHCA) [5, 6], but we thought this might not be correct because the values of rSO2 always change depending on the patient’s situation at the time cerebral rSO2 is measured [7]
The pre-hospital portable monitoring of cerebral rSO2 in cardiopulmonary arrest (CPA) patients with OHCA was approved by the Ethics Committee of Osaka University Graduate School of Medicine (No 12446), and the institutional review board waived the need for informed consent because the subjects were all in CPA
Summary
Measurement of cerebral regional oxygen saturation (rSO2) has attracted attention during resuscitation. The objective of this study was to clarify serial changes in cerebral rSO2 of patients with out-of-hospital cardiac arrest (OHCA) in the prehospital setting. Measurement of cerebral regional oxygen saturation (rSO2) by near-infrared spectroscopy (NIRS) has attracted attention in many fields [1,2,3,4]. We thought that it might be useful for the development of a new resuscitation strategy. The objective of this study was to clarify serial changes in cerebral rSO2 of patients with out-of-hospital cardiac arrest in the pre-hospital setting
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
