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Is jugular bulb oximetry monitoring associated with outcome in out of hospital cardiac arrest patients?
Cerebral protection against secondary hypoxic-ischemic brain injury is a key priority area in post-resuscitation intensive care management in survivors of cardiac arrest. Nevertheless, the current understanding of the incidence, diagnosis and its’ impact on neurological outcome remains undetermined....
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Netherlands
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8286927/ https://www.ncbi.nlm.nih.gov/pubmed/32435933 http://dx.doi.org/10.1007/s10877-020-00530-x |
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author | Richter, Jaromir Sklienka, Peter Setra, Adarsh Eshappa Zahorec, Roman Das, Samaresh Chatterjee, Nilay |
author_facet | Richter, Jaromir Sklienka, Peter Setra, Adarsh Eshappa Zahorec, Roman Das, Samaresh Chatterjee, Nilay |
author_sort | Richter, Jaromir |
collection | PubMed |
description | Cerebral protection against secondary hypoxic-ischemic brain injury is a key priority area in post-resuscitation intensive care management in survivors of cardiac arrest. Nevertheless, the current understanding of the incidence, diagnosis and its’ impact on neurological outcome remains undetermined. The aim of this study was to evaluate jugular bulb oximetry as a potential monitoring modality to detect the incidences of desaturation episodes during post-cardiac arrest intensive care management and to evaluate their subsequent impact on neurological outcome. We conducted a prospective, observational study in unconscious adult patients admitted to the intensive care unit who had successful resuscitation following out of hospital cardiac arrest of presumed cardiac causes. All the patients were treated as per European Resuscitation Council 2015 guidelines and they received jugular bulb catheter. Jugular bulb oximetry measurements were performed at six hourly intervals. The neurological outcomes were evaluated on 90th day after the cardiac arrest by cerebral performance categories scale. Forty patients met the eligibility criteria. Measurements of jugular venous oxygen saturation were performed for 438 times. Altogether, we found 2 incidences of jugular bulb oxygen saturation less than 50% (2/438; 0.46%), and 4 incidences when it was less than 55% (4/438; 0.91%). The study detected an association between SjVO(2) and CO(2) (r = 0.26), each 1 kPa increase in CO(2) led to an increase in SjvO(2) by 3.4% + / − 0.67 (p < 0.0001). There was no association between SjvO(2) and PaO(2) or SjvO(2) and MAP. We observed a statistically significant higher mean SjvO(2) (8.82% + / − 2.05, p < 0.0001) in unfavorable outcome group. The episodes of brain hypoxia detected by jugular bulb oxygen saturation were rare during post-resuscitation intensive care management in out of hospital cardiac arrest patients. Therefore, this modality of monitoring may not yield any additional information towards prevention of secondary hypoxic ischemic brain injury in post cardiac arrest survivors. Other factors contributing towards high jugular venous saturation needs to be considered. |
format | Online Article Text |
id | pubmed-8286927 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Netherlands |
record_format | MEDLINE/PubMed |
spelling | pubmed-82869272021-07-20 Is jugular bulb oximetry monitoring associated with outcome in out of hospital cardiac arrest patients? Richter, Jaromir Sklienka, Peter Setra, Adarsh Eshappa Zahorec, Roman Das, Samaresh Chatterjee, Nilay J Clin Monit Comput Original Research Cerebral protection against secondary hypoxic-ischemic brain injury is a key priority area in post-resuscitation intensive care management in survivors of cardiac arrest. Nevertheless, the current understanding of the incidence, diagnosis and its’ impact on neurological outcome remains undetermined. The aim of this study was to evaluate jugular bulb oximetry as a potential monitoring modality to detect the incidences of desaturation episodes during post-cardiac arrest intensive care management and to evaluate their subsequent impact on neurological outcome. We conducted a prospective, observational study in unconscious adult patients admitted to the intensive care unit who had successful resuscitation following out of hospital cardiac arrest of presumed cardiac causes. All the patients were treated as per European Resuscitation Council 2015 guidelines and they received jugular bulb catheter. Jugular bulb oximetry measurements were performed at six hourly intervals. The neurological outcomes were evaluated on 90th day after the cardiac arrest by cerebral performance categories scale. Forty patients met the eligibility criteria. Measurements of jugular venous oxygen saturation were performed for 438 times. Altogether, we found 2 incidences of jugular bulb oxygen saturation less than 50% (2/438; 0.46%), and 4 incidences when it was less than 55% (4/438; 0.91%). The study detected an association between SjVO(2) and CO(2) (r = 0.26), each 1 kPa increase in CO(2) led to an increase in SjvO(2) by 3.4% + / − 0.67 (p < 0.0001). There was no association between SjvO(2) and PaO(2) or SjvO(2) and MAP. We observed a statistically significant higher mean SjvO(2) (8.82% + / − 2.05, p < 0.0001) in unfavorable outcome group. The episodes of brain hypoxia detected by jugular bulb oxygen saturation were rare during post-resuscitation intensive care management in out of hospital cardiac arrest patients. Therefore, this modality of monitoring may not yield any additional information towards prevention of secondary hypoxic ischemic brain injury in post cardiac arrest survivors. Other factors contributing towards high jugular venous saturation needs to be considered. Springer Netherlands 2020-05-20 2021 /pmc/articles/PMC8286927/ /pubmed/32435933 http://dx.doi.org/10.1007/s10877-020-00530-x Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Research Richter, Jaromir Sklienka, Peter Setra, Adarsh Eshappa Zahorec, Roman Das, Samaresh Chatterjee, Nilay Is jugular bulb oximetry monitoring associated with outcome in out of hospital cardiac arrest patients? |
title | Is jugular bulb oximetry monitoring associated with outcome in out of hospital cardiac arrest patients? |
title_full | Is jugular bulb oximetry monitoring associated with outcome in out of hospital cardiac arrest patients? |
title_fullStr | Is jugular bulb oximetry monitoring associated with outcome in out of hospital cardiac arrest patients? |
title_full_unstemmed | Is jugular bulb oximetry monitoring associated with outcome in out of hospital cardiac arrest patients? |
title_short | Is jugular bulb oximetry monitoring associated with outcome in out of hospital cardiac arrest patients? |
title_sort | is jugular bulb oximetry monitoring associated with outcome in out of hospital cardiac arrest patients? |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8286927/ https://www.ncbi.nlm.nih.gov/pubmed/32435933 http://dx.doi.org/10.1007/s10877-020-00530-x |
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