Application of cerebral oxygen saturation to prediction of the futility of resuscitation for out-of-hospital cardiopulmonary arrest patients: a single-center, prospective, observational study

Cerebral oximetry and return of spontaneous circulation after cardiac arrest: A systematic review and meta-analysis

“…Of the nine findings included in the data for meta-analysis, five studies evaluated out-of-hospital CA (OHCA) patients only, 10,[17][18][19][20] other two studies included only patients presenting with inhospital CA (IHCA), 13,21 and two studies included both OHCA and IHCA populations. 9,22 Different devices have been used in these studies (Table 2).…”

“…Moreover the time delay between CA and the first application of the NIRS probe was not available which may greatly influence the first recorded rSO 2 value. In this context, it is worth highlighting that two studies were conducted in Japan 18,19 where emergency medical personnel are not allowed to terminate resuscitation out of the hospital, increasing the heterogeneity in the results of the meta-analysis. Second, all the studies included are fairly small range of 15-69 patients and were single centre based.…”

“…9 Four studies provided data on initial values of NIRS in OHCA patients: one study recorded data immediately at the arrival of medical emergency team to the OHCA, 17 one reported values gathered from rSO 2 sensor applied to the right forehead of both IHCA and OHCA patients at the beginning of resuscitation, 22 while two Japanese studies provided rSO 2 data promptly measured at Emergency Department arrival. 18,19 The remaining four studies recorded the average rSO 2 value from the initial recording until the CPR was ended (ROSC vs death). 10,13,20,21 ROSC was associated with significantly higher values of rSO 2 compared to the population that did not achieve ROSC.…”

Near-infrared spectroscopy during cardiopulmonary resuscitation and after restoration of spontaneous circulation

“…Storm et al [37] found that cardiac arrest patients with good neurologic outcome had significantly higher rSO 2 levels (CPC 1-2 median rSO 2 68%, CPC 3-5 median rSO 2 58%, P < 0.01). The same pattern was found within the first 24 h and during the rewarming period of 16 h [38]. ROC analysis for outcome prediction found the highest area under the curve for rSO 2 threshold of 50% (AUC 0.80; specificity 70% and sensitivity 86%) [37].…”

“…Fukuda et al [38] used INVOS rSO 2 to evaluate if CPR was futile. On hospital arrival patients who did not achieve ROSC had significantly lower rSO 2 than those with ROSC (18.2 vs. 28.5%, P ¼ 0.0002).…”