Near infrared spectrophotometry (cerebral oximetry) in predicting the return of spontaneous circulation in out-of-hospital cardiac arrest

Kalkan, Ahmet; Ersunan, Gökhan; Bilir, Özlem; Yavaşı, Özcan; Deniz, Ozel; Kayayurt, Kamil; Ziyan, Murat; Aydin, C.; Yeniocak, Selman

doi:10.1016/j.ajem.2013.09.010

Cited by 41 publications

(31 citation statements)

References 17 publications

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“…In that subgroup, heterogeneity was too high for meta‐analysis (I 2 = 89%). This can be explained by the fact that four studies showed a large difference in highest oximetry measurements between patients who experienced ROSC and those who did not, while three studies showed a much smaller difference (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Among the included studies, only the five abstracts were evaluated as being at high risk of bias . Nine of the remaining studies were at intermediate risk of bias and six were at low risk of bias . The description of the risk of bias for each included study is presented in Table and specified in Data Supplement S1.…”

Section: Resultsmentioning

confidence: 99%

“…Also, Sanfilippo chose to include only studies that presented mean and initial oximetry measures, while studies presenting the highest oximetry measures were excluded. Despite the high heterogeneity between these studies, the result presented is the only one available so far and is therefore useful for a large number of clinician using NIRS to such avail . Third, instead of using the median, we used Wan's technique, a more precise statistical method, to estimate the mean and SD .…”

Section: Discussionmentioning

confidence: 99%

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Near‐infrared Spectroscopy Monitoring During Cardiac Arrest: A Systematic Review and Meta‐analysis

Cournoyer

Iseppon

Chauny

et al. 2016

Academic Emergency Medicine

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Background: Tissue oximetry using near-infrared spectroscopy (NIRS) is a noninvasive monitor of cerebral oxygenation. This new technology has been used during cardiac arrest (CA) because of its ability to give measures in low-blood-flow situations. The aim of this study was to assess the evidence regarding the association between the types of NIRS measurements (mean, initial, and highest values) and resuscitation outcomes (return of spontaneous circulation [ROSC], survival to discharge, and good neurologic outcome) in patients undergoing cardiopulmonary resuscitation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Near‐infrared Spectroscopy Monitoring During Cardiac Arrest: A Systematic Review and Meta‐analysis

Cournoyer

Iseppon

Chauny

et al. 2016

Academic Emergency Medicine

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“…Because rSO 2 may reflect the balance between oxygen delivery and regional (frontal) cerebral metabolism, the product of blood Hb levels and cerebral oxygen saturation could parallel oxygen delivery during resuscitation. Therefore, rSO 2 measured during CPR attempts could indicate whether the ongoing attempt is likely to sustain adequate oxygen delivery to cerebral tissues [31]. …”

Section: Discussionmentioning

confidence: 99%

Estimated cerebral oxyhemoglobin as a useful indicator of neuroprotection in patients with post-cardiac arrest syndrome: a prospective, multicenter observational study

et al. 2014

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IntroductionLittle is known about oxyhemoglobin (oxy-Hb) levels in the cerebral tissue during the development of anoxic and ischemic brain injury. We hypothesized that the estimated cerebral oxy-Hb level, a product of Hb and regional cerebral oxygen saturation (rSO2), determined at hospital arrival may reflect the level of neuroprotection in patients with post-cardiac arrest syndrome (PCAS).MethodsThe Japan Prediction of neurological Outcomes in patients with Post cardiac arrest (J-POP) registry is a prospective, multicenter, cohort study to test whether rSO2 predicts neurologic outcomes after out-of-hospital cardiac arrest (OHCA). This study assessed a subgroup of consecutive patients who fulfilled the J-POP registry criteria and successfully achieved return of spontaneous circulation (ROSC) from OHCA. The primary outcome measure was the neurologic status at 90 days.ResultsWe analyzed data from 495 consecutive comatose survivors who were successfully resuscitated from OHCA, including 119 comatose patients with prehospital return of spontaneous circulation (ROSC; 24.0%) and 376 cardiac arrests at hospital arrival. In total, 75 patients (15.1%) presented with good neurologic outcomes. Univariate analysis revealed that the cerebral oxy-Hb levels were significantly higher in patients with good outcomes. Multivariate logistic regression using the backward-elimination method confirmed that the oxy-Hb level was a significant predictor of good neurologic outcomes (adjusted odds ratio, 1.27; 95% confidence interval (CI), 1.11 to 1.46). Analysis of the area under the receiver operating characteristic curve (AUC) revealed that an oxy-Hb cut-off of 5.5 provided optimal sensitivity and specificity for predicting good neurologic outcomes (AUC, 0.87; 95% CI, 0.83 to 0.91; sensitivity, 77.3%; specificity, 85.6%). The oxy-Hb level appeared to be an excellent prognostic indicator with significant advantages over rSO2 and base excess, according to AUC analysis. The significant trend for good neurologic outcomes was consistent, even in the subgroup of patients who achieved return of spontaneous circulation on hospital arrival (1st quartile, 0; 2nd quartile, 16.7%; 3rd quartile, 29.4%; 4th quartile, 53.3%; P < 0.05).ConclusionsThe cerebral oxy-Hb level may predict neurologic outcomes and is a simple and excellent indicator of neuroprotection in patients with PCAS.Trial registrationUMIN Clinical Trials Registry UMIN000005065. Registered 1 April 2011.

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“…We found a good degree of correlation between cerebral and abdominal saturations, which supports our previous study. The implication in both studies is that abdominal saturation determination alone can be indicative of ROSC [23].…”

Section: Discussionmentioning

confidence: 99%

Abdominal oxygen saturation for monitoring return of spontaneous circulation in out-of-hospital cardiac arrest using near infrared spectrophometry

Kalkan¹,

Bilir²,

Ersunan³

et al. 2015

The American Journal of Emergency Medicine

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Near infrared spectrophotometry (cerebral oximetry) in predicting the return of spontaneous circulation in out-of-hospital cardiac arrest

Cited by 41 publications

References 17 publications

Near‐infrared Spectroscopy Monitoring During Cardiac Arrest: A Systematic Review and Meta‐analysis

Near‐infrared Spectroscopy Monitoring During Cardiac Arrest: A Systematic Review and Meta‐analysis

Estimated cerebral oxyhemoglobin as a useful indicator of neuroprotection in patients with post-cardiac arrest syndrome: a prospective, multicenter observational study

Abdominal oxygen saturation for monitoring return of spontaneous circulation in out-of-hospital cardiac arrest using near infrared spectrophometry

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