Cerebral oxygen saturation monitoring in pediatric cardiopulmonary resuscitation patients in the emergency settings: A small descriptive study

Abstract

Çağlar A, Er A, Ulusoy E, Akgül F, Çitlenbik H, Yılmaz D, Duman M. Cerebral oxygen saturation monitoring in pediatric cardiopulmonary resuscitation patients in the emergency settings: A small descriptive study. Turk J Pediatr 2017; 59: 642-647. Near infrared spectroscopy (NIRS) is a new technology for monitoring cardiopulmonary resuscitation (CPR). The use of NIRS has advantages in monitoring cerebral oxygenation in cardiac arrest patients. The aim of this study was to describe cerebral regional oxygen saturation (CrSO < sub > 2 < /sub > ) values in a small cohort of pediatric out-of-hospital cardiac arrest patients and to determine if there is an association with CrSO < sub > 2 < /sub > and return of spontaneous circulation (ROSC). All the out-of-hospital cardiac arrest patients admitted to our pediatric emergency department were included in this prospective study. All patients were monitored through NIRS in addition to standard monitoring during CPR. All cerebral rSO < sub > 2 < /sub > measurements were obtained with an INVOS 5100C cerebral/somatic oximeter. Cardiopulmonary resuscitation was performed according to the Pediatric Advanced Life Support 2010 guidelines. The patients were classified as ROSC and non - ROSC. Ten patients were included in this study. The median age of patients was 40.0 (14.0-88.2) months. Three (30%) of the 10 patients achieved sustained ROSC. Abrupt increase in cerebral regional oxygen saturation (CrSO < sub > 2 < /sub > ) was observed in all 3 of these patients. Minimum values of the CrSO < sub > 2 < /sub > were significantly lower and the percentage of median time with CrSO < sub > 2 < /sub > under 30% of CrSO < sub > 2 < /sub > were significantly higher in the non - ROSC group (p=0.02). Our study indicated that the patients in the non - ROSC group have lower minimum CrSO < sub > 2 < /sub > value. Additionally, abrupt increase of CrSO < sub > 2 < /sub > during CPR could be an indicator for ROSC.

Pediatric Life Support

“…The second small study found an association between higher minimum rS O 2 during CPR and ROSC, 98 but overall survival was too low to detect changes in survival. An adult observational study found ETCO 2 to be a more accurate predictor of ROSC in OHCA.…”

“…One found that cerebral physiological changes were associated with changed NIRS measurements during cardiac arrest, increased intracranial pressure reduction, arrest resolution, and after ROSC. 97 The second small study found an association between higher minimum rSO 2 during CPR and ROSC, 98 but overall survival was too low to detect changes in survival. An adult observational study found [ 1 1 3 3 _ T D $ D I F F ] ETCO 2 to be a more accurate predictor of ROSC in OHCA.…”

Lebensrettende Maßnahmen bei Kindern (Paediatric Life Support, PLS)

“…Der verwandte ILCOR PLS 2020 identifizierte 2 kleine Beobachtungsstudien [ 742 , 743 ]. Die Literatur für Erwachsene ist umfangreicher, aber das Maß an Evidenz ist immer noch gering.…”

Pediatric Life Support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

“…One found that cerebral physiological changes were associated with changed NIRS measurements during cardiac arrest, increased intracranial pressure reduction, arrest resolution, and after ROSC. 97 The second small study found an association between higher minimum rSco 2 during CPR and ROSC, 98 but overall survival was too low to detect changes in survival. An adult observational study found ETCO 2 to be a more accurate predictor of ROSC in OHCA.…”