Regional Cerebral Oximetry During Cardiopulmonary Resuscitation: Useful or Useless?

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• 作者：Cornelia Genbrugge ; MD^&lowast ; ; ^&dagger ; ; ; Jo Dens ; MD ; PhD^&dagger ; ; ^&Dagger ; ; Ingrid Meex ; Msc^&lowast ; ; ^&dagger ; ; Willem Boer ; MD^&lowast ; ; Ward Eertmans ; Msc^&lowast ; ; ^&dagger ; ; Marc Sabbe ; MD ; PhD^§ ; ; Frank Jans ; MD ; PhD^&lowast ; ; ^&dagger ; ; Cathy De Deyne ; MD ; PhD^&lowast ; ; ^&dagger ;
• 关键词：advanced life support ; cardiac arrest ; cardiopulmonary resuscitation ; cerebral tissue saturation ; neuromonitoring ; NIRS ; out-of-hospital cardiac arrest ; prehospital
• 刊名：Journal of Emergency Medicine
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：50
• 期：1
• 页码：198-207
• 全文大小：331 K

文摘

Approximately 375,000 people annually experience sudden cardiac arrest (CA) in Europe. Most patients who survive the initial hours and days after CA die of postanoxic brain damage. Current monitors, such as electrocardiography and end-tidal capnography, provide only indirect information about the condition of the brain during cardiopulmonary resuscitation (CPR). In contrast, cerebral near-infrared spectroscopy provides continuous, noninvasive, real-time information about brain oxygenation without the need for a pulsatile blood flow. It measures transcutaneous cerebral tissue oxygen saturation (rSO₂). This information could supplement currently used monitors. Moreover, an evolution in rSO₂ monitoring technology has made it easier to assess rSO₂ in CA conditions.

Objective

We give an overview of the literature regarding rSO₂ measurements during CPR and the current commercially available devices. We highlight the feasibility of cerebral saturation measurement during CPR, its role as a quality parameter of CPR, predictor of return of spontaneous circulation (ROSC) and neurologic outcome, and its monitoring function during transport.

Discussion

rSO₂ is feasible in the setting of CA and has the potential to measure the quality of CPR, predict ROSC and neurologic outcome, and monitor post-CA patients during transport.

Conclusion

The literature shows that rSO₂ has the potential to serve multiple roles as a neuromonitoring tool during CPR and also to guide neuroprotective therapeutic strategies.