Abstract 272: Significant Difference in Increase in Cerebral Saturation Between Patients with and Without ROSC During Prehospital Advanced Life Support
Introduction and Objectives: During out-of hospital cardiac arrest (OHCA) monitoring possibilities are limited. Recently, the possible role of cerebral oximetry, using near infrared spectroscopy, during ALS was investigated. In this study we determined whether the extent of increase in cerebral saturation (rSO2) during ALS was associated with return of spontaneous circulation (ROSC) during ALS.
Material and Methods: With IRB approval, we prospectively measured rSO2 during ALS in consecutive OHCA patients. One sensor of the EquanoxTM 7600 (NONIN) was applied on patient’s forehead’s right side when the medical emergency team arrived in an out-hospital resuscitation setting. Monitoring was continued until the patient arrived at the ICU or when resuscitation attempt were discontinued. ROSC was defined as ROSC > 20 min.
Results: Between December 2011 and November 2013, we included 49 patients of which 19 achieved ROSC. There were 8 male patients (42.11%) in the ROSC group compared to 23 male patients (76.67%) in the no-ROSC group (p = 0.032). Time between emergency call and start ALS was significant longer in the no-ROSC group (14 min (12-17.25) versus 12 min (8-15) in the ROSC group (p = 0.011). Age, initial rhythm, witnessed arrest and start of basic life support by bystanders was similar in both groups. The gradual increase from initial rSO2 value until ROSC or end of ALS efforts, was significantly larger in the group with ROSC (18% (15 - 33)) compared to the no-ROSC group (9.5% (4 - 15); p < 0.001). If even only data were included from start ALS until one min before ROSC, the difference in increase remained significant (16% (11 - 36) vs 9.5% (4 - 15); p = 0.002). Median duration of ALS until ROSC was 16 min (10-30). If we compare rSO2 from start of measurement until ROSC or until 16 min in the no-ROSC group (18 patients), a significant increase is observed namely 11.5% (7.25-16.75) for the no-ROSC group vs 18% (15-33) for the ROSC group (p = 0.004).
Conclusion: This study demonstrates that patients who will achieve ROSC have a steeper increase in rSO2 compared to patients who don’t achieve ROSC. This was moreover confirmed by a significant difference in rSO2 at the moment of ROSC compared to the same point (16min) in no-ROSC patients.
Author Disclosures: C. Genbrugge: None. I. Meex: None. F. Jans: None. C. De Deyne: None. W. Boer: None. J. Dens: None.
- © 2014 by American Heart Association, Inc.