Abstract 17802: The Role of Cerebral Oxygenation as a Real Time Monitoring Tool in Cardiac Arrest
Introduction: Regional cerebral oxygen saturation (rSO2) as measured by near infrared frontal cerebral spectroscopy (NIRS) has been shown to decrease in circulatory arrest and increase with high quality cardiopulmonary resuscitation (CPR). Evidence is limited on the relationship between rSO2 levels and survival to discharge in cardiac arrest.
Hypothesis: We hypothesized a significant association between rSO2 level, code survival and survival to discharge.
Methods: This prospective case series included patients experiencing in-hospital cardiac arrest. rSO2 values were recorded continuously at the beginning of cardiac arrest until ROSC, at ROSC, and up to 48 hours following the achievement of ROSC. The average rSO2 was also obtained. Relationship between median initial rSO2, rSO2 at ROSC, rSO2at survival, and average rSO2 with code survival and survival to discharge was statistically analyzed.
Results: The study cohort consisted of 27 patients of which 26 were men; 61% (n=19) achieved ROSC, and 29% (n=8) survived to discharge. The median duration of cardiac arrest events was 19 minutes (IQR = 8-74). There is a significant association between rSO2 level at ROSC and code survival (X2 = 22.2, p = 0.036). There are no significant associations between rSO2 level at any time during cardiac arrest and survival outcomes. As reported in the table, there is a significant difference between the rSO2 levels for survivors and non-survivors. Notably, one patient had increased rSO2 levels following the institution of therapeutic hypothermia for cardiac arrest.
Conclusion: Higher rSO2 levels obtained at ROSC are associated with code survival, and may reflect high quality CPR. However, rSO2 values obtained at the beginning of CPR, and following ROSC may not correlate with 48-hour post-ROSC survival or survival to discharge. Larger trials are needed to evaluate the use of cerebral oximetry as a real time monitoring tool in CPR and during the post cardiac arrest phase.
- © 2012 by American Heart Association, Inc.