Abstract 20486: Noninvasive Regional Cerebral Oxygen Saturation Can Predict Poor Brain Resuscitation in Patients with Out-of-Hospital Cardiac Arrest
Background: Brain protection therapy for patients in the acute phase after out-of-hospital cardiac arrest (OHCA), has nowadays greatly improved thanks to the chain of survival and emergency post-cardiac-arrest interventions. When a patient arrives at a hospital in cardiopulmonary arrest, there is no time to consider whether or not we should perform emergency post-cardiac-arrest interventions to maintain brain function. If an objective index could enable earlier prediction of a patient's brain resuscitation, it would help to determine treatment strategies as quickly as possible. In previous studies monitoring regional cerebral oxygen saturation (rSO2) during cardiovascular surgery has been shown to predict brain injury in relation to cerebral ischemia.
Objective: We measured real-time rSO2 in OHCA patients immediately on arrival at the hospital to determine whether the rSO2 during the hyper-acute phase could serve as a predictor of brain resuscitation at discharge.
Methods: 82 consecutive non-trauma, cardiopulmonary arrest on arrival (CPAOA) patients over the age of 18 were prospectively included. Of a total of 82 patients, rSO2 were measured with sensors placed on either side of their forehead using a near-infrared spectroscopy (NIRS) device (INVOS, Somanetics, Troy, MI) within three minutes of arrival at hospital. Clinical staff performed ordinary post-cardiac-arrest interventions regardless of rSO2. This study has been approved by the Osaka Saiseikai Senri Hospital Ethics Committee.
Results: 13 patients with favorable brain resuscitation had higher rSO2 than the other 69 patients with poor brain resuscitation (51.8+/−13.0% vs. 24.2+/−14.8%, p<0.001). All patients with rSO2 of < 25% showed poor brain resuscitation by performing receiver operating curve (ROC) analysis (figure).
Conclusions: rSO2 is an easily obtained novel index for estimating poor brain resuscitation in patients with CPAOA.
- © 2010 by American Heart Association, Inc.