Prehospital monitoring of cerebral circulation during out of hospital cardiac arrest ? A feasibility study

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Original Research

Joakim Björås¹  Oskar Angerås²  Niklas Bergh²  Peter Lundgren³  Johan Herlitz⁴  Anna Henningsson⁵  Bengt Redfors⁶  Lukas Lannemyr⁶ 

[1] Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Region Västra Götaland, Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden;Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Region Västra Götaland, Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden;Prehospen - Centre for Prehospital Research, University of Borås, Borås, Sweden;Prehospen - Centre for Prehospital Research, University of Borås, Borås, Sweden;Region Västra Götaland, Sahlgrenska University Hospital, Section of Cardiothoracic Anaesthesia and Intensive Care, Göteborg, Sweden;Region Västra Götaland, Sahlgrenska University Hospital, Section of Cardiothoracic Anaesthesia and Intensive Care, Göteborg, Sweden;Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;

关键词: Cerebral oximetry;    Regional cerebral oxygen saturation;    Cardiac arrest;    EMS;   

DOI  :  10.1186/s13049-022-01044-y

 received in 2022-07-01, accepted in 2022-10-15,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundAbout two-thirds of the in-hospital deaths after out-of-hospital cardiac arrests (OHCA) are a consequence of anoxic brain injuries, which are due to hypoperfusion of the brain during the cardiac arrests. Being able to monitor cerebral perfusion during cardiopulmonary resuscitation (CPR) is desirable to evaluate the effectiveness of the CPR and to guide further decision making and prognostication.MethodsTwo different devices were used to measure regional cerebral oxygen saturation (rSO2): INVOS™ 5100 (Medtronic, Minneapolis, MN, USA) and Root® O3 (Masimo Corporation, Irvine, CA, USA). At the scene of the OHCA, advanced life support (ALS) was immediately initiated by the Emergency Medical Services (EMS) personnel. Sensors for measuring rSO2 were applied at the scene or during transportation to the hospital. rSO2 values were documented manually together with ETCO2 (end tidal carbon dioxide) on a worksheet specially designed for this study. The study worksheet also included a questionnaire for the EMS personnel with one statement on usability regarding potential interference with ALS.ResultsTwenty-seven patients were included in the statistical analyses. In the INVOS™5100 group (n = 13), the mean rSO2 was 54% (95% CI 40.3–67.7) for patients achieving a return of spontaneous circulation (ROSC) and 28% (95% CI 12.3–43.7) for patients not achieving ROSC (p = 0.04). In the Root® O3 group (n = 14), the mean rSO2 was 50% (95% CI 46.5–53.5) and 41% (95% CI 36.3–45.7) (p = 0.02) for ROSC and no ROSC, respectively. ETCO2 values were not statistically different between the groups. The EMS personnel graded the statement of interference with ALS to a median of 2 (IQR 1–6) on a 10-point Numerical Rating Scale.ConclusionOur results suggest that both INVOS™5100 and ROOT® O3 can distinguish between ROSC and no ROSC in OHCA, and both could be used in the pre-hospital setting and during transport with minimal interference with ALS.

【 授权许可】

CC BY   
© The Author(s) 2022

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