Abstract 16932: The Possibility of Real-Time Monitoring by Regional Cerebral Oxygen Saturation (rSO2) as an Indicator of Quality of Chest Compression and Neurological outcomes for Cardiogenic 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 cardiogenic PCAS patients.
Patients and Methods: Consecutive 32 cardiogenic OHCA patients who were admitted to our critical care unit after ROSC and could evaluate the neurological outcomes in 90th days after cardiac arrest for the latest thirty-one months were included. The level of rSO2 were monitored at three phases, Phase1; during manual chest compression, Phase2; compressing by 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 90th days after cardiac arrest.
Results: Twelve patients presented favorable outcome (38%). The rSO2 of Phase1 was 27.5+/-14.8%. It was significantly increased at Phase2 (33.7+/-10.9%, p<0.01) and more increased at Phase3 (47.9+/-12.2%, p<0.01). There were negative correlation between the rSO2 and neurological outcome in only Phase1(r=-0.41 p<0.05). But all patients whose neurological outcomes were good could achieve over 25% rSO2 during CPR.
Conclusions: The level of rSO2 for cardiogenic OHCA patients were Manual<ACD<ROSC and avoiding lower rSO2 during CPR would avert poor neurological outcome. Monitoring rSO2 level and achieving higher rSO2 during CPR may be important as an indicator of quality of chest compression and for better neurological outcomes of cardiogenic OHCA patients.
- © 2013 by American Heart Association, Inc.