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Pre-hospital portable monitoring of cerebral regional oxygen saturation (rSO(2)) by ambulance personnel during cardiopulmonary resuscitation: A prospective observational analysis of 87 cases in Osaka city, Japan

BACKGROUND: Regional cerebral oxygen saturation (rSO(2)) is a non-invasive method of measuring cerebral perfusion; However, serial changes in cerebral rSO(2) values among out-of-hospital cardiac arrest (OHCA) patients in pre-hospital settings have not been sufficiently investigated. We aimed to inve...

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Autores principales: Sakai, Tomohiko, Hirose, Tomoya, Shiozaki, Tadahiko, Takagawa, Ryosuke, Ohnishi, Mitsuo, Hayashida, Sumito, Shigematsu, Shinji, Satou, Keiichi, Takemoto, Yasunori, Shimazu, Takeshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8244519/
https://www.ncbi.nlm.nih.gov/pubmed/34223358
http://dx.doi.org/10.1016/j.resplu.2021.100093
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author Sakai, Tomohiko
Hirose, Tomoya
Shiozaki, Tadahiko
Takagawa, Ryosuke
Ohnishi, Mitsuo
Hayashida, Sumito
Shigematsu, Shinji
Satou, Keiichi
Takemoto, Yasunori
Shimazu, Takeshi
author_facet Sakai, Tomohiko
Hirose, Tomoya
Shiozaki, Tadahiko
Takagawa, Ryosuke
Ohnishi, Mitsuo
Hayashida, Sumito
Shigematsu, Shinji
Satou, Keiichi
Takemoto, Yasunori
Shimazu, Takeshi
author_sort Sakai, Tomohiko
collection PubMed
description BACKGROUND: Regional cerebral oxygen saturation (rSO(2)) is a non-invasive method of measuring cerebral perfusion; However, serial changes in cerebral rSO(2) values among out-of-hospital cardiac arrest (OHCA) patients in pre-hospital settings have not been sufficiently investigated. We aimed to investigate the association between the serial change in rSO(2) pattern and patient outcome. METHODS: We evaluated rSO(2) in OHCA patients using portable monitoring by emergency life-saving technicians (ELTs) from June 2013 to December 2019 in Osaka City, Japan. We divided the patterns of serial of rSO(2) change into type 1 (increasing pattern) and type 2 (non-increasing pattern). Patients in whom measurement started after return of spontaneous circulation (ROSC) were excluded. The outcome measures were ‘Prehospital ROSC’, ‘Alive at admission’, ‘1-month survival’ and ‘Cerebral Performance Category (CPC) 1 or 2′. RESULTS: Eighty-seven patients were eligible for this analysis (type 1: n = 40, median age: 80.5 [IQR: 72–85.5] years, male: n = 20 [50.0%]; type 2: n = 47, 81 [72–85.5] years, male: n = 28 [59.6%]). In a multivariable logistic regression adjusted for confounding factors, outcomes of ‘Prehospital ROSC’ and ‘Alive at admission’ were significantly higher in type 1 than type 2 pattern (11/40 [27.5%] vs. 2/47 [4.26%], AOR 5.67, 95% CI 1.04–30.96, p < 0.045 and 17/40 [42.5%] vs. 6/41 [12.8%], AOR 3.56, 95% CI 1.11–11.43, p < 0.033). There was no significant difference in ‘1-month survival’ and ‘CPC 1 or 2′ between patterns. CONCLUSION: Type 1 (increasing pattern) was associated with ‘Prehospital ROSC’ and ‘Alive at admission’. Pre-hospital monitoring of cerebral rSO(2) might lead to a new resuscitation strategy.
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spelling pubmed-82445192021-07-02 Pre-hospital portable monitoring of cerebral regional oxygen saturation (rSO(2)) by ambulance personnel during cardiopulmonary resuscitation: A prospective observational analysis of 87 cases in Osaka city, Japan Sakai, Tomohiko Hirose, Tomoya Shiozaki, Tadahiko Takagawa, Ryosuke Ohnishi, Mitsuo Hayashida, Sumito Shigematsu, Shinji Satou, Keiichi Takemoto, Yasunori Shimazu, Takeshi Resusc Plus Clinical Paper BACKGROUND: Regional cerebral oxygen saturation (rSO(2)) is a non-invasive method of measuring cerebral perfusion; However, serial changes in cerebral rSO(2) values among out-of-hospital cardiac arrest (OHCA) patients in pre-hospital settings have not been sufficiently investigated. We aimed to investigate the association between the serial change in rSO(2) pattern and patient outcome. METHODS: We evaluated rSO(2) in OHCA patients using portable monitoring by emergency life-saving technicians (ELTs) from June 2013 to December 2019 in Osaka City, Japan. We divided the patterns of serial of rSO(2) change into type 1 (increasing pattern) and type 2 (non-increasing pattern). Patients in whom measurement started after return of spontaneous circulation (ROSC) were excluded. The outcome measures were ‘Prehospital ROSC’, ‘Alive at admission’, ‘1-month survival’ and ‘Cerebral Performance Category (CPC) 1 or 2′. RESULTS: Eighty-seven patients were eligible for this analysis (type 1: n = 40, median age: 80.5 [IQR: 72–85.5] years, male: n = 20 [50.0%]; type 2: n = 47, 81 [72–85.5] years, male: n = 28 [59.6%]). In a multivariable logistic regression adjusted for confounding factors, outcomes of ‘Prehospital ROSC’ and ‘Alive at admission’ were significantly higher in type 1 than type 2 pattern (11/40 [27.5%] vs. 2/47 [4.26%], AOR 5.67, 95% CI 1.04–30.96, p < 0.045 and 17/40 [42.5%] vs. 6/41 [12.8%], AOR 3.56, 95% CI 1.11–11.43, p < 0.033). There was no significant difference in ‘1-month survival’ and ‘CPC 1 or 2′ between patterns. CONCLUSION: Type 1 (increasing pattern) was associated with ‘Prehospital ROSC’ and ‘Alive at admission’. Pre-hospital monitoring of cerebral rSO(2) might lead to a new resuscitation strategy. Elsevier 2021-03-02 /pmc/articles/PMC8244519/ /pubmed/34223358 http://dx.doi.org/10.1016/j.resplu.2021.100093 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Paper
Sakai, Tomohiko
Hirose, Tomoya
Shiozaki, Tadahiko
Takagawa, Ryosuke
Ohnishi, Mitsuo
Hayashida, Sumito
Shigematsu, Shinji
Satou, Keiichi
Takemoto, Yasunori
Shimazu, Takeshi
Pre-hospital portable monitoring of cerebral regional oxygen saturation (rSO(2)) by ambulance personnel during cardiopulmonary resuscitation: A prospective observational analysis of 87 cases in Osaka city, Japan
title Pre-hospital portable monitoring of cerebral regional oxygen saturation (rSO(2)) by ambulance personnel during cardiopulmonary resuscitation: A prospective observational analysis of 87 cases in Osaka city, Japan
title_full Pre-hospital portable monitoring of cerebral regional oxygen saturation (rSO(2)) by ambulance personnel during cardiopulmonary resuscitation: A prospective observational analysis of 87 cases in Osaka city, Japan
title_fullStr Pre-hospital portable monitoring of cerebral regional oxygen saturation (rSO(2)) by ambulance personnel during cardiopulmonary resuscitation: A prospective observational analysis of 87 cases in Osaka city, Japan
title_full_unstemmed Pre-hospital portable monitoring of cerebral regional oxygen saturation (rSO(2)) by ambulance personnel during cardiopulmonary resuscitation: A prospective observational analysis of 87 cases in Osaka city, Japan
title_short Pre-hospital portable monitoring of cerebral regional oxygen saturation (rSO(2)) by ambulance personnel during cardiopulmonary resuscitation: A prospective observational analysis of 87 cases in Osaka city, Japan
title_sort pre-hospital portable monitoring of cerebral regional oxygen saturation (rso(2)) by ambulance personnel during cardiopulmonary resuscitation: a prospective observational analysis of 87 cases in osaka city, japan
topic Clinical Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8244519/
https://www.ncbi.nlm.nih.gov/pubmed/34223358
http://dx.doi.org/10.1016/j.resplu.2021.100093
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