Abstract 123: The Possibility of Real-Time Monitoring by Regional Cerebral Oxygen Saturation (rSo2) as an Indicator of Quality of Chest Compression Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest Patients
Backgrounds and Objective: It has been suggested that brain tissue oxygenation is crucial for a prognosis in post cardiac arrest syndrome (PCAS). Recently several studies have suggested that regional cerebral oxygen saturation (rSO2) of the hyperacute phase is one of the promising predictor for a better neurological outcome in PCAS patients (ex; rSO2>25% avert poor neurological outcome possibility). Other studies have reported a positive correlation between rSO2 and coronary perfusion pressure during chest compression cardiopulmonary resuscitation (CPR). But it is still unknown whether the changes of rSO2 level during CPR affect to a better neurological outcome. So we studied the relationships between the real-time rSO2 level during CPR and a short-term neurological outcome in PCAS patients.
Methods: Consecutive 44 non-traumatic OHCA patients who were admitted to our critical care unit after ROSC for the latest twenty months were included. The level of rSO2 were monitored at three phases, Phase1; during manual chest compression, Phase2; using automatic chest compression device (ACD), Phase3; after ROSC. We examined the changes of the rSO2 of each phase and the correlation between them and neurological outcomes (CPC 1 or 2 were favorable) in 30th days after cardiac arrest.
Results: Seven patients presented favorable outcome (16%). The rSO2 of Phase1 was 23.6+/-13.3%. It was significantly increased at Phase2 (29.7+/-14.0%, p<0.01) and more increased at Phase3 (41.1+/-15.1%, p<0.05). There were negative correlation between the rSO2 of Phase1 and neurological outcome (r=-0.412, p<0.01) and same as at Phase3 (r=-0.314, p<0.05).
Conclusions: The level of rSO2 for OHCA patients were Manual<ACD<ROSC and avoiding lower rSO2 as early as possible would avert poor neurological outcome. It may be important to monitor the rSO2 level during CPR as an indicator of quality of chest compression.
- © 2012 by American Heart Association, Inc.