Near-Infrared Spectroscopy Assessments of Regional Cerebral Oxygen Saturation for the Prediction of Clinical Outcomes in Patients With Cardiac Arrest: A Review of Clinical Impact, Evolution, and Future Directions

Frontiers in Medicine

article

Ryosuke Takegawa¹  Kei Hayashida¹  Daniel M. Rolston²  Timmy Li²  Santiago J. Miyara¹  Mitsuo Ohnishi³  Tadahiko Shiozaki³  Lance B. Becker¹ 

[1] Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, Northwell Health System, United States;Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, United States;Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine;Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, United States;Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, United States;Elmezzi Graduate School of Molecular Medicine, United States;Department of Acute Medicine and Critical Care Medical Center, Osaka National Hospital, National Hospital Organization

关键词: cardiac arrest;    cardiopulmonary resuscitation;    near-infrared spectroscopy;    cerebral oxygen saturation;    brain oximetry;    ROSC;    neurological outcome;    prognostication;   

DOI  :  10.3389/fmed.2020.587930

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Despite three decades of advancements in cardiopulmonary resuscitation (CPR) methods and post-resuscitation care, neurological prognosis remains poor among survivors of out-of-hospital cardiac arrest, and there are no reliable methods for predicting neurological outcomes in patients with cardiac arrest (CA). Adopting more effective methods of neurological monitoring may aid in improving neurological outcomes and optimizing therapeutic interventions for each patient. In the present review, we summarize the development, evolution, and potential application of near-infrared spectroscopy (NIRS) in adults with CA, highlighting the clinical relevance of NIRS brain monitoring as a predictive tool in both pre-hospital and in-hospital settings. Several clinical studies have reported an association between various NIRS oximetry measurements and CA outcomes, suggesting that NIRS monitoring can be integrated into standardized CPR protocols, which may improve outcomes among patients with CA. However, no studies have established acceptable regional cerebral oxygen saturation cut-off values for differentiating patient groups based on return of spontaneous circulation status and neurological outcomes. Furthermore, the point at which resuscitation efforts can be considered futile remains to be determined. Further large-scale randomized controlled trials are required to evaluate the impact of NIRS monitoring on survival and neurological recovery following CA.

【 授权许可】

CC BY