Abstract 42: Trending Cerebral Oximetry and Mean Arterial Pressure Post Cardiac Arrest to Predict Neurological Outcome
Background: Currently there is no early predictor of neurologic outcome following resuscitation from cardiac arrest, this prognosticator could drive patient care and direct resource utilization. Cerebral Oximetry (CerOx) non-invasively monitor regional brain oxygen saturation and correlates well with jugular venous saturation and is predictive of neurologic outcome.
Study Objective: To determine Cerebral Oximetry trends predictive of good neurologic outcome in the first 24 hours after ROSC.
Methods: CerOx data was collected continuously from ROSC through 24 hours. Mean Arterial Pressure (MAP) was recorded at least hourly for the first 24 hours. Patients were grouped as such: cooled with bad outcome (CBO), cooled with good outcome (CGO), uncooled with bad outcome (UBO), and uncooled with good outcome (UGO). Cooled patients were therapeutically induced to 33.5°C. Good neurologic outcome (GNO) was defined as a CPC of < 3. Pearson Correlations were performed on MAP and CerOx on each group.
Results: Data was collected on 66 subjects. 51 patients were cooled with 16% (8/51) with good outcomes. 15 patients were not cooled and 67% (10/15), had good outcomes. Correlation of CerOx and MAP over the first 5 hours post-ROSC revealed no correlation in UGO r = 0.1 and a strong negative correlation in UBO, r=-0.75. CGO group had an r=-0.78 and the CBO a r=0.29 and a moderate correlation. Both cohorts with good neurologic outcome had increasing MAP within the first 4 hours. This data suggest a lack of auto-regulation in those with poor outcomes. Note the UBO had high correlation during decreasing MAP while the CGO had it during elevation in MAP.
Conclusion: Lack of correlation between MAP and CerOx or little change in CerOx with elevated MAP portends a better outcome
- Cardiac arrest
- Cardiopulmonary resuscitation
- Return of spontaneous circulation (ROSC)
- Patient care
Author Disclosures: M. Jamil: None. C. Thomas: None. T. Engel: None. B. Reed: None. P. Medado: None. B.J. O’Neil: None.
- © 2014 by American Heart Association, Inc.