Characteristics of regional cerebral oxygen saturation levels in patients with out-of-hospital cardiac arrest with or without return of spontaneous circulation

A prospective observational multicentre study

Kei Nishiyama, Noritoshi Ito, Tomohiko Orita, Kei Hayashida, Hideki Arimoto, Mitsuru Abe, Takashi Unoki, Tomoyuki Endo, Akira Murai, Ken Ishikura, Noriaki Yamada, Masahiro Mizobuchi, Hideaki Anan, Tomorou Watanabe, Hideto Yasuda, Yosuke Homma, Kazuhiro Shiga, Michiaki Tokura, Yuka Tsujimura, Tetsuo Hatanaka & 1 others Ken Nagao

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Aim: Our study aimed at filling the fundamental knowledge gap on the characteristics of regional brain oxygen saturation (rSO2) levels in out-of-hospital cardiac arrest (OHCA) patients with or without return of spontaneous circulation (ROSC) upon arrival at the hospital for estimating the quality of cardiopulmonary resuscitation and neurological prognostication in these patients. Methods: We enrolled 1921 OHCA patients from the Japan - Prediction of Neurological Outcomes in Patients Post-cardiac Arrest Registry and measured their rSO2 immediately upon arrival at the hospital by near-infrared spectroscopy using two independent forehead probes (right and left). We also assessed the percentage of patients with a good neurological outcome (defined as cerebral performance categories 1 or 2) 90 days post cardiac arrest. Results: After 90 days, 79 (4%) patients had good neurological outcomes and a median lower rSO2 level of 15% (15-20%). Compared to patients without ROSC upon arrival at the hospital, those with ROSC had significantly higher rSO2 levels (56% [39-65%] vs. 15% [15-17%], respectively; P<0.01), and significantly correlated right- and left-sided regional brain oxygen saturation levels (R=0.94 vs. 0.66, respectively). In both groups, the percentage of patients with a good 90-day neurological outcome increased significantly in proportion to their rSO2 levels upon arrival at the hospital (P<0.01). Conclusion: Our data indicate that measuring rSO2 levels might be effective for both monitoring the quality of resuscitation and neurological prognostication in patients with OHCA.

Original languageEnglish
Pages (from-to)16-22
Number of pages7
JournalResuscitation
Volume96
DOIs
Publication statusPublished - 2015 Nov 1

Fingerprint

Out-of-Hospital Cardiac Arrest
Multicenter Studies
Observational Studies
Oxygen
Heart Arrest
Forehead
Near-Infrared Spectroscopy
Cardiopulmonary Resuscitation
Brain
Resuscitation
Registries
Japan

Keywords

  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Cerebrovascular circulation
  • Near-infrared spectroscopy
  • Oxygen
  • Prognoses

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

Cite this

Characteristics of regional cerebral oxygen saturation levels in patients with out-of-hospital cardiac arrest with or without return of spontaneous circulation : A prospective observational multicentre study. / Nishiyama, Kei; Ito, Noritoshi; Orita, Tomohiko; Hayashida, Kei; Arimoto, Hideki; Abe, Mitsuru; Unoki, Takashi; Endo, Tomoyuki; Murai, Akira; Ishikura, Ken; Yamada, Noriaki; Mizobuchi, Masahiro; Anan, Hideaki; Watanabe, Tomorou; Yasuda, Hideto; Homma, Yosuke; Shiga, Kazuhiro; Tokura, Michiaki; Tsujimura, Yuka; Hatanaka, Tetsuo; Nagao, Ken.

In: Resuscitation, Vol. 96, 01.11.2015, p. 16-22.

Research output: Contribution to journalArticle

Nishiyama, K, Ito, N, Orita, T, Hayashida, K, Arimoto, H, Abe, M, Unoki, T, Endo, T, Murai, A, Ishikura, K, Yamada, N, Mizobuchi, M, Anan, H, Watanabe, T, Yasuda, H, Homma, Y, Shiga, K, Tokura, M, Tsujimura, Y, Hatanaka, T & Nagao, K 2015, 'Characteristics of regional cerebral oxygen saturation levels in patients with out-of-hospital cardiac arrest with or without return of spontaneous circulation: A prospective observational multicentre study', Resuscitation, vol. 96, pp. 16-22. https://doi.org/10.1016/j.resuscitation.2015.07.013
Nishiyama, Kei ; Ito, Noritoshi ; Orita, Tomohiko ; Hayashida, Kei ; Arimoto, Hideki ; Abe, Mitsuru ; Unoki, Takashi ; Endo, Tomoyuki ; Murai, Akira ; Ishikura, Ken ; Yamada, Noriaki ; Mizobuchi, Masahiro ; Anan, Hideaki ; Watanabe, Tomorou ; Yasuda, Hideto ; Homma, Yosuke ; Shiga, Kazuhiro ; Tokura, Michiaki ; Tsujimura, Yuka ; Hatanaka, Tetsuo ; Nagao, Ken. / Characteristics of regional cerebral oxygen saturation levels in patients with out-of-hospital cardiac arrest with or without return of spontaneous circulation : A prospective observational multicentre study. In: Resuscitation. 2015 ; Vol. 96. pp. 16-22.
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T1 - Characteristics of regional cerebral oxygen saturation levels in patients with out-of-hospital cardiac arrest with or without return of spontaneous circulation

T2 - A prospective observational multicentre study

AU - Nishiyama, Kei

AU - Ito, Noritoshi

AU - Orita, Tomohiko

AU - Hayashida, Kei

AU - Arimoto, Hideki

AU - Abe, Mitsuru

AU - Unoki, Takashi

AU - Endo, Tomoyuki

AU - Murai, Akira

AU - Ishikura, Ken

AU - Yamada, Noriaki

AU - Mizobuchi, Masahiro

AU - Anan, Hideaki

AU - Watanabe, Tomorou

AU - Yasuda, Hideto

AU - Homma, Yosuke

AU - Shiga, Kazuhiro

AU - Tokura, Michiaki

AU - Tsujimura, Yuka

AU - Hatanaka, Tetsuo

AU - Nagao, Ken

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Aim: Our study aimed at filling the fundamental knowledge gap on the characteristics of regional brain oxygen saturation (rSO2) levels in out-of-hospital cardiac arrest (OHCA) patients with or without return of spontaneous circulation (ROSC) upon arrival at the hospital for estimating the quality of cardiopulmonary resuscitation and neurological prognostication in these patients. Methods: We enrolled 1921 OHCA patients from the Japan - Prediction of Neurological Outcomes in Patients Post-cardiac Arrest Registry and measured their rSO2 immediately upon arrival at the hospital by near-infrared spectroscopy using two independent forehead probes (right and left). We also assessed the percentage of patients with a good neurological outcome (defined as cerebral performance categories 1 or 2) 90 days post cardiac arrest. Results: After 90 days, 79 (4%) patients had good neurological outcomes and a median lower rSO2 level of 15% (15-20%). Compared to patients without ROSC upon arrival at the hospital, those with ROSC had significantly higher rSO2 levels (56% [39-65%] vs. 15% [15-17%], respectively; P<0.01), and significantly correlated right- and left-sided regional brain oxygen saturation levels (R=0.94 vs. 0.66, respectively). In both groups, the percentage of patients with a good 90-day neurological outcome increased significantly in proportion to their rSO2 levels upon arrival at the hospital (P<0.01). Conclusion: Our data indicate that measuring rSO2 levels might be effective for both monitoring the quality of resuscitation and neurological prognostication in patients with OHCA.

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KW - Cardiac arrest

KW - Cardiopulmonary resuscitation

KW - Cerebrovascular circulation

KW - Near-infrared spectroscopy

KW - Oxygen

KW - Prognoses

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