Abstract 286: The Efficacy of Real-Time Monitoring by Regional Cerebral Oxygen Saturation During Chest Compression Cardiopulmonary Resuscitation for Avoiding Poor Neurological Outcome
Backgrounds and Objective: It has suggested that some real-time monitoring system during cardiopulmonary resuscitation (CPR) would need for better neurological outcomes of post cardiac arrest syndrome (PCAS) patients. Recently some studies have reported that regional cerebral oxygen saturation (rSO2) of out of hospital cardiac arrest (OHCA) patients would be one of the promising predictor for neurological outcomes of them. But it is still unclear the relationships between rSO2 level during CPR and neurological outcomes in PCAS patients. So we studied whether the rSO2 values during CPR is useful as a real-time monitoring in OHCA patients.
Methods: Consecutive 121 non-traumatic 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 forty-eight 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 relationship between them and neurological outcomes (CPC 1 or 2 were favorable) in 90th days after cardiac arrest.
Results: Thirty-eight patients presented favorable outcome (31%). The rSO2 of Phase1 was 23.8+/-14.8%. It was significantly increased at Phase2 (33.1+/-19.1%, p<0.01) and more increased at Phase3 (47.2+/-15.8%, p<0.01). The amount of change from Manual to ROSC in CPC1/2 vs CPC3/4/5 was 14.8% vs 30.5% (p<0.05). And that from ACD to ROSC was 13.7 vs 19.3 (p=0.51).
Discussion/Conclusions: The rSO2 values of OHCA patients were Manual<ACD<ROSC and bigger differences between during CPR and after ROSC related poor neurological outcomes. It may be reflect the quality of chest compression and cerebral perfusion volume. So it would be important to try to achieve higher rSO2 during CPR with monitoring it for better neurological outcomes.
Author Disclosures: T. Orita: None. Y. Toyoda: None. Y. Nakamichi: None. M. Yamazaki: None. T. Funabiki: None. M. Shimizu: None. S. Matsumoto: None. T. Sato: None. Y. Kobayashi: None. N. Hiroe: None. T. Kazamaki: None. M. Kitano: None.
- © 2014 by American Heart Association, Inc.