The pitfalls of bedside regional cerebral oxygen saturation in the early stage of post cardiac arrest

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Shingo Ihara¹  Atsushi Sakurai¹  Kosaku Kinoshita¹ 

[1] Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi Itabashi-ku, Tokyo 173-8610, Japan

关键词: Amplitude-integrated electroencephalography;    Regional cerebral oxygen saturation;    Post-cardiac arrest patients;    Cardiac arrest;   

Others  :  1234482
DOI  :  10.1186/s13049-015-0173-4

 received in 2015-05-23, accepted in 2015-10-28,  发布年份 2015

【 摘 要 】

It remains uncertain whether neuromonitoring reliably predicts outcome in adult post-cardiac arrest patients in the early stage treated with therapeutic hypothermia. Recent reports demonstrated a regional cerebral oxygen saturation of cardiac arrest patients on hospital arrival could predict their neurological outcome. There has been little discussion about the significance of regional cerebral oxygen saturation in patients with post-cardiac arrest syndrome. Amplitude-integrated electroencephalography monitoring may also provide early prognostic information for post-cardiac arrest syndrome. However, even when the initial electroencephalography is flat after the return of spontaneous circulation, good neurological outcome may still be obtainable if the electroencephalography shifts to a continuous pattern. The electroencephalography varied from flat to various patterns, such as flat, epileptic, or continuous during the first 24 h, while regional cerebral oxygen saturation levels varied even when the electroencephalography was flat. It is therefore difficult to estimate whether regional cerebral oxygen saturation accurately indicates the coupling of cerebral blood flow and metabolism in the early stage after cardiac arrest. Careful assessment of prognosis is necessary when relying solely on regional cerebral oxygen saturation as a single monitoring modality.

【 授权许可】

   
2015 Kinoshita et al.

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