Abstract 131: Serial Changes in Values of Cerebral Regional Saturation of Oxygen During Resuscitation in Patients With Out-of-Hospital Cardiac Arrest
Background: Regional saturation of oxygen (rSO2), also known as “tissue oxygen saturation” or “local mixed blood oxygen saturation”, indicates the change in the balance of oxygen supply and demand. Although we can find some studies that analyzed cerebral rSO2 during resuscitation, none of them analyzed serial changes, and the data during use of extracorporeal membrane oxygenation in cardiopulmonary resuscitation (ECPR) seems to be insufficient.
Objective: To clarify serial changes in cerebral rSO2 during resuscitation of patients with out-of-hospital cardiac arrest (OHCA).
Methods: We prospectively analyzed data from 39 patients with OHCA whose rSO2 were measured serially from July 2012 to January 2013. Patients with trauma or intracranial event were excluded. Cerebral rSO2 was measured from the left forehead using TOS-OR. Patients were divided into 4 groups, group A with return of spontaneous circulation (ROSC) after hospital arrival, group B with no ROSC, group C with ROSC before hospital arrival, and group D with ECPR. Normal range of rSO2 was determined from 18 healthy volunteers to be median 72.0% (interquartile range (IQR), 71.2-72.5%).
Results: Group A consisted of 14 patients (mean [±SD] age, 72.8±16.2 years), group B of 17 patients (68.8±5.2 years), group C of 5 patients (60.4±21.2 years) and group D of 3 patients (52.3±8.7 years). In group A and B, rSO2 on hospital arrival was median 47.2 % (IQR, 41.7-55.9) and 46.4% (38.7-52.7) respectively, which went up to 66.5% (64.3-71.9) and 49.8% (43.6-55.5) at the highest. In group A, the amount of increase was 2.8% (1.2-10.6) before ROSC and 14.7% (5.5-21.1) after ROSC. Cerebral rSO2 increased significantly after ROSC (p<0.01). In group C, rSO2 on hospital arrival was 71.5% (69.1-72.3), which was as high as the healthy. In group D, during ECPR application, rSO2 increased from47.2 to 74.1 %( case 1, dead), from57.8 to 62.9 %( case 2, survived) and from54.5 to 55.2 %( case 3, survived). This increase seemed to be caused by ECPR, because patients did not have spontaneous circulation at that time.
Conclusions: Chest compression only could not increase rSO2 in patients with OHCA, but it increased with ROSC. Cerebral rSO2 may reflect cerebral blood flow during resuscitation.
- © 2013 by American Heart Association, Inc.