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|Title: ||Start value of cerebral saturation in pre-hospital cardiac arrest patients: does it mean something?|
|Authors: ||Genbrugge, C.|
De Deyne, C.
|Issue Date: ||2013|
|Citation: ||International symposium on intensive care and emergency medicine, Brussels, Belgium, March 19-22 2013|
During cardiopulmonary resuscitation (CPR) monitoring possibilities are limited. Parnia et al. investigated the
feasibility and role of near infra-red spectroscopy (NIRS) during CPR in cardiac arrest patients (CA)(1). NIRS
could have a role in predicting return of spontaneous circulation (ROSC). Recently, the Equanox® with four
wavelengths sensor was validated to provide absolute data on regional cerebral saturation(2). We measured
cerebral oxygenation (rSO2) during CPR with NIRS technology and analyzed the differences between initial
cerebral saturations in patients achieving ROSC compared to patients without ROSC.
With IRB approval, rSO2 was measured with NIRS during resuscitation in 18 out-of hospital CA patients. The
Equanox® advance (NONIN), a NIRS monitoring device which measure absolute rSO2 values, was applied on
the right side of the patient’s forehead when the medical emergency team arrived in a resuscitation setting.
Placement of the probe did not interfere with the advanced life support algorithm. The sensor remained on the
patient’s forehead during resuscitation and if ROSC was reached, the probe was removed on arrival at the
emergency department. If ROSC was not achieved, the probe was removed pre-hospital. ROSC was defined as
return of spontaneous circulation during more than 20 minutes. Mann-Whitney test was utilized for comparison
of survivor and non-survivors data. Student t-test was performed to compare the initial rSO2.
Of the 18 patients, 9 patients had ROSC (survivors). The initial rhythm was the same in both groups, 6 patients in
each group had asystole as initial rhythm. In the group of survivors were 6 female patients, in the non-survivors
2 female patients. The mean age in ROSC and no-ROSC group is respectively 75,8yr (SD±12,8) and 69,4yr
(SD±22,9, p=0,48). The mean rSO2 at arrival of the emergency medical team was 31,56 % (SD±29,4) and 12,78%
(SD±12,7) respectively in the ROSC group and no-ROSC group (p=0,1). Mean time between collaps and start
CPR (basic life support of bystanders) was 6,9 minutes (SD±8,2) in the no-ROSC group and 8,2 minutes (SD±7,08,
p=0,69) in the ROSC group.
Initial rSO2 values in out-of hospital CA patients with ROSC, showed a tendency towards higher values
compared with non-survivors, but no significant difference could be demonstrated, probably related to the small
number of patients included in this preliminary report.|
|Type: ||Conference Material|
|Appears in Collections: ||Research publications|
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