Cerebral saturation in cardiac arrest patients measured with near-infrared technology during pre-hospital advanced life support. Results from Copernicus I cohort study

Abstract

Regional cerebral saturation measurements can be used during pre-hospital ALS as an additional marker to predict ROSC. An increase of at least 15% in rSO during ALS is associated with a higher probability of ROSC.

Effects of therapeutic hypothermia on cerebral tissue oxygen saturation in a swine model of post‑cardiac arrest

“…This decrease could be explained by the onset of different pathophysiological mechanisms after cardiac arrest. During 5 min of CPR, a steep increase in S ct O 2 was observed, which is likely to be related the initiation of CPR, as described in a previous study (32).…”

Near‐infrared spectroscopy monitoring in a pre‐hospital trauma patient cohort: An analysis of successful signal collection

“…The proportion of pre-hospital time with successful monitoring (>70%) was 71.4% (45 of 63) for all three sensors, with at least two sensors functional in 90.4% (57 of 63). The median (interquartile range) scene time was 19 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) minutes in patients with NIRS monitoring compared to 18 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) minutes without NIRS monitoring (P = .570). There was no difference in the median (interquartile range) total pre-hospital time between patients with or without monitoring sensors (72 [59-89] versus 72 [59-80] minutes; P = .605).…”

“…For time spent at the scene, there was no difference between the three patient groups (Table 1); patients with or without NIRS monitoring also had similar scene times (P = .570). In the sensitivity analysis, the median (IQR) scene time for those with sensors applied who met the inclusion criteria (n = 53) was 19 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) with no difference between patients with and without NIRS monitoring (P = .867). For total pre-hospital time, there was no difference between the three patient groups (Table 1); patients with or without NIRS monitoring also had similar total pre-hospital time (P = .605).…”

“…18 Coupled with feasibility evidence in out-of-hospital cardiac arrest management, the promise of NIRS oximetry is still evident, though these reports have not focussed as extensively on the proportion of successful monitoring and often rely on a single NIRS sensor. [19][20][21] With extracranial contamination and ambient light in an operating theatre environment previously highlighted as potential issues, the demonstration that outdoor ambient light does not preclude monitoring is reassuring. 22,23 The goal of NIRS monitoring should be to provide information that responds accurately enough to evolving changes in physiology to allow clinicians to make meaningful changes to their care and produce better patient outcomes.…”

How near is near infrared spectroscopy in pre‐hospital care?

“…Pre‐hospital NIRS monitoring has been applied almost exclusively in out of hospital cardiac arrest patients during ongoing resuscitation, whilst the results of these studies support the feasibility of NIRS monitoring and its value in detecting return of spontaneous circulation . Patients with major trauma with and without traumatic brain injury patients may of course differ, especially concerning the possible presence of treatable intracranial lesions that may increase intracranial pressure and hamper cerebral perfusion.…”