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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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Open Access 01-12-2016 | Original research

Good neurological outcome despite very low regional cerebral oxygen saturation during resuscitation—a prospective preclinical trial in 29 patients

Authors: Christian Storm, Alexander Wutzler, Lars Trenkmann, Alexander Krannich, Sabrina von Rheinbarben, Fridolin Luckenbach, Jens Nee, Natalie Otto, Tim Schroeder, Christoph Leithner

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2016

Abstract

Background

Noninvasive regional cerebral oxygen saturation (rSO₂) measurement using near-infrared spectroscopy (NIRS) might inform on extent and duration of cerebral hypoxia during cardiopulmonary resuscitation (CPR). This information may be used to guide resuscitation efforts and may carry relevant early prognostic information.

Methods

We prospectively investigated non-traumatic out-of-hospital cardiac arrest (OHCA) patients on scene. NIRS was started either during CPR or shortly after (<2 min) return of spontaneous circulation (ROSC) by emergency medical service (EMS). Outcome was determined at intensive care unit (ICU) discharge and 6 months after cardiac arrest.

Results

A total of 29 OHCA patients were included. In 23 patients NIRS was started during CPR and in 6 patients immediately after ROSC. 18 (62.1 %) patients did not reach ROSC. Initial rSO₂ during CPR was very low (<50 % in all 23 patients, < 30 % in 19 of 23 patients) with no significant difference between patients achieving ROSC and those who did not. Of five patients with ROSC, in whom NIRS was recorded during CPR, two reached a good six-months outcome (initial rSO₂ 22 %) and three died during the ICU stay (initial rSO₂ 15, 16 and 46 %). In six patients with NIRS started immediately after ROSC (<2 min), rSO2 was substantially higher (54–85 %) than in patients during CPR (p = 0.006).

Discussion and conclusion

Initial frontal brain rSO₂ determined by NIRS during CPR was generally very low and recovered rapidly after ROSC. Very low initial rSO₂ during CPR was compatible with good neurological outcome in our limited cohort of patients. Further studies are needed to assess in larger cohorts and more detail the implications of very low initial rSO₂ during CPR on scene.

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Title: Good neurological outcome despite very low regional cerebral oxygen saturation during resuscitation—a prospective preclinical trial in 29 patients
Authors: Christian Storm
Alexander Wutzler
Lars Trenkmann
Alexander Krannich
Sabrina von Rheinbarben
Fridolin Luckenbach
Jens Nee
Natalie Otto
Tim Schroeder
Christoph Leithner
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2016
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/s13049-016-0234-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Good neurological outcome despite very low regional cerebral oxygen saturation during resuscitation—a prospective preclinical trial in 29 patients

Abstract

Background

Methods

Results

Discussion and conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Discussion and conclusion

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