Abstract 106: Effect of Prehospital Portable Monitoring of Cerebral Regional Oxygen Saturation in Patients with Out-of-Hospital Cardiac Arrest
Introduction: In recent years, measurement of cerebral regional oxygen saturation (rSO2) has attracted attention during resuscitation. However, serial changes of cerebral rSO2 in pre-hospital settings are unclear. The objective of this study was to clarify serial changes in cerebral rSO2 of patients with out-of-hospital cardiac arrest in the pre-hospital setting.
Hypothesis: A pre-hospital portable cerebral rSO2 monitoring system would be useful device in resuscitation.
Methods: We developed a portable rSO2 monitor (HAND ai TOS®), which is small enough to carry in pre-hospital settings. The sensor is attached to the patient’s forehead by the Emergency Life-saving Technician (ELT), and it monitors rSO2 continuously. The normal range of rSO2 was determined from 15 healthy patients.
Results: The normal range of rSO2 was 71.2±3.9%. From June 2013 through February 2014, serial changes of cerebral rSO2 in 4 patients were evaluated. In three patients in cardiopulmonary arrest when the ELT started cerebral rSO2 measurement (1 man, 2 women; mean age, 54.0±10.1 years), mean rSO2 was 51.4±10.1% at the time measurement was started and was 51.5±5.5% just before hospital arrival. None of these patients had return of spontaneous circulation (ROSC) in the pre-hospital setting. In the one patient (86-year-old woman) with ROSC when ELT started cerebral rSO2 measurement, cerebral rSO2 was 67.3% at measurement start, it dropped gradually to 54.5%, and then rose to 74.3% (Figure). The cerebral oxygenation was impaired due to possible cardiac arrest again, and after that, ROSC led to the recovery of cerebral blood flow.
Conclusions: By carrying out continuous measurement of cerebral rSO2 in the pre-hospital setting, the changes of cerebral oxygenation were detected. Further evaluation of the validity of pre-hospital cerebral rSO2 monitoring may lead to a new resuscitation strategy in the pre-hospital setting.
Author Disclosures: T. Hirose: None. T. Shiozaki: Research Grant; Significant; Grant-in Aid for Scientific research from the Ministry of Education, Culture, Sports, Science, and Technology in Japan (no. 24390401). J. Nomura: None. K. Katsura: None. N. Ehara: None. A. Wakai: None. M. Ohnishi: None. S. Hayashida: None. D. Sadamitsu: None. T. Shimazu: None.
- © 2014 by American Heart Association, Inc.