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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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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. |
format | Online Article Text |
id | pubmed-8244519 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
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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