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Open Access 01-04-2013 | Research

Feasibility of absolute cerebral tissue oxygen saturation during cardiopulmonary resuscitation

Authors: Ingrid Meex, Cathy De Deyne, Jo Dens, Simon Scheyltjens, Kevin Lathouwers, Willem Boer, Guy Vundelinckx, René Heylen, Frank Jans

Published in: Critical Care | Issue 2/2013

Abstract

Introduction

Current monitoring during cardiopulmonary resuscitation (CPR) is limited to clinical observation of consciousness, breathing pattern and presence of a pulse. At the same time, the adequacy of cerebral oxygenation during CPR is critical for neurological outcome and thus survival. Cerebral oximetry, based on near-infrared spectroscopy (NIRS), provides a measure of brain oxygen saturation. Therefore, we examined the feasibility of using NIRS during CPR.

Methods

Recent technologies (FORE-SIGHT™ and EQUANOX™) enable the monitoring of absolute cerebral tissue oxygen saturation (SctO₂) values without the need for pre-calibration. We tested both FORE-SIGHT™ (five patients) and EQUANOX Advance™ (nine patients) technologies in the in-hospital as well as the out-of-hospital CPR setting. In this observational study, values were not utilized in any treatment protocol or therapeutic decision. An independent t-test was used for statistical analysis.

Results

Our data demonstrate the feasibility of both technologies to measure cerebral oxygen saturation during CPR. With the continuous, pulseless near-infrared wave analysis of both FORE-SIGHT™ and EQUANOX™ technology, we obtained SctO₂ values in the absence of spontaneous circulation. Both technologies were able to assess the efficacy of CPR efforts: improved resuscitation efforts (improved quality of chest compressions with switch of caregivers) resulted in higher SctO₂ values. Until now, the ability of CPR to provide adequate tissue oxygenation was difficult to quantify or to assess clinically due to a lack of specific technology. With both technologies, any change in hemodynamics (for example, ventricular fibrillation) results in a reciprocal change in SctO₂. In some patients, a sudden drop in SctO₂ was the first warning sign of reoccurring ventricular fibrillation.

Conclusions

Both the FORE-SIGHT™ and EQUANOX™ technology allow non-invasive monitoring of the cerebral oxygen saturation during CPR. Moreover, changes in SctO₂ values might be used to monitor the efficacy of CPR efforts.

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Title: Feasibility of absolute cerebral tissue oxygen saturation during cardiopulmonary resuscitation
Authors: Ingrid Meex
Cathy De Deyne
Jo Dens
Simon Scheyltjens
Kevin Lathouwers
Willem Boer
Guy Vundelinckx
René Heylen
Frank Jans
Publication date: 01-04-2013
Publisher: BioMed Central
Published in: Critical Care / Issue 2/2013
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc12546

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Feasibility of absolute cerebral tissue oxygen saturation during cardiopulmonary resuscitation

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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