Cerebral perfusion pressure and cerebral tissue oxygen tension in a patient during cardiopulmonary resuscitation

Abstract

In the clinical setting of a witnessed cardiac arrest, immediate institution of CPR can be effective in generating PbrO(2) values above a supposed ischaemic/hypoxic threshold when CPP is >25 mmHg. PbrO(2) monitoring by the Licox system is sensitive and reliable, even at low values, and can be suitable for evaluating cerebral oxygenation during experimental CPR.

Neurologically Intact Survival after Prolonged Cardiopulmonary Resuscitation for Pulseless Ventricular Tachycardia

“…To date, there are limited studies of cerebral oximetry during cardiac arrest. 3,4 Our patient showed an increase in his regional hemoglobin oxygen saturation (rSO 2 ) after return of spontaneous circulation to values exceeding 50%. The threshold for cerebral hypoperfusion in patients with unknown baseline is less than 50% (Figure).…”

“…This finding is in line with literature documenting that high-quality cardiopulmonary resuscitation is associated with the successful return of cerebral oxygenation. 3 Cerebral rSO 2 decreases in circulatory arrest but increases during cardiopulmonary resuscitation. 8 The literature on the use of cerebral oximetry as a monitoring device during cardiac arrest is limited, and the actual rSO 2 level that predicts return of spontaneous circulation remains unknown.…”

Towards interventional trials on the use of oxygen during and after cardiac arrest

“…In an elegant case report from 2003, oxygen values during CPR were measured in an invasively monitored neurosurgical patient who had an iatrogenic cardiac arrest. 12 This case suggests that during CPR, oxygen measured in parenchyma of the brain is related mainly to perfusion pressure and less so to arterial oxygen content. Perfusion pressure during CPR can only be achieved with high-quality chest compressions.…”

Systematic and Comprehensive Literature Review of Publications on Direct Cerebral Oxygenation Monitoring

“…A pbtO2 monitoring course during cardiopulmonary resuscitation [80], and a course of Vein of Labbe thrombosis [81] have been published as case reports. One case report presents the effects of high-dose inhaled aerosolized prostacyclin therapy for acute lung injury on cerebral oxygenation [82].…”