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

Wik, Lars

doi:10.1097/mcc.0000000000000301

Cited by 10 publications

(4 citation statements)

References 50 publications

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“…Probes may also be influenced by ambient light. [58] J o u r n a l P r e -p r o o f Finally, the value of cerebral oxygen saturation for the prognostication on neurological outcome after CA is at early stage of research, and it could not be properly analysed. More studies are warranted to understand the relationship between initial and overall values of cerebral oxygen saturation with neurological outcome after CA.…”

Section: Limitationsmentioning

confidence: 99%

Cerebral regional oxygen saturation during cardiopulmonary resuscitation and return of spontaneous circulation: A systematic review and meta-analysis

Sanfilippo¹,

Murabito²,

Messina³

et al. 2021

Resuscitation

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Section: Limitationsmentioning

confidence: 99%

Cerebral regional oxygen saturation during cardiopulmonary resuscitation and return of spontaneous circulation: A systematic review and meta-analysis

Sanfilippo¹,

Murabito²,

Messina³

et al. 2021

Resuscitation

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“…In contrast to pulse oximetry, NIRS can measure tissue oxygenation in the absence of pulsatile flow, without the need to interrupt chest compressions ( 55 , 57 , 62 ). Since NIRS values are affected by ambient light ( 52 , 77 ), some devices cannot be used outside. Nonetheless, rSO 2 monitoring may aid in the early detection of ROSC and re-arrest in patients with CA ( 55 – 57 , 62 ).…”

Section: Use Of Nirs For Earlier Detection Of Re-arrest In Prehospitamentioning

confidence: 99%

Near-Infrared Spectroscopy Assessments of Regional Cerebral Oxygen Saturation for the Prediction of Clinical Outcomes in Patients With Cardiac Arrest: A Review of Clinical Impact, Evolution, and Future Directions

et al. 2020

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Despite three decades of advancements in cardiopulmonary resuscitation (CPR) methods and post-resuscitation care, neurological prognosis remains poor among survivors of out-of-hospital cardiac arrest, and there are no reliable methods for predicting neurological outcomes in patients with cardiac arrest (CA). Adopting more effective methods of neurological monitoring may aid in improving neurological outcomes and optimizing therapeutic interventions for each patient. In the present review, we summarize the development, evolution, and potential application of near-infrared spectroscopy (NIRS) in adults with CA, highlighting the clinical relevance of NIRS brain monitoring as a predictive tool in both pre-hospital and in-hospital settings. Several clinical studies have reported an association between various NIRS oximetry measurements and CA outcomes, suggesting that NIRS monitoring can be integrated into standardized CPR protocols, which may improve outcomes among patients with CA. However, no studies have established acceptable regional cerebral oxygen saturation cut-off values for differentiating patient groups based on return of spontaneous circulation status and neurological outcomes. Furthermore, the point at which resuscitation efforts can be considered futile remains to be determined. Further large-scale randomized controlled trials are required to evaluate the impact of NIRS monitoring on survival and neurological recovery following CA.

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“…As NIRS measures the oxygen saturation in all vessels <1 mm diameter (including arteries, capillaries and venules) (26), it can provide readings in instances of low blood flow, independently of pulsatile flow, including the flow exhibited during cardiac arrest. Its prognostic value has been validated in recent studies (5,27). NIRS could offer a large clinical benefit in that it alerts clinicians promptly, enabling implementation of corrective interventions.…”

Section: Discussionmentioning

confidence: 99%

“…As a result, cerebral blood flow might be reduced, regardless of normal blood pressure. Some studies have shown that severe brain damage might cause metabolic depression and hyperemia and that increased S ct O 2 may occur in the very early stage of post-cardiac arrest syndrome (8,27). Therefore, the significance of higher or lower S ct O 2 in the early post-resuscitation phase remains to be elucidated.…”

Section: Discussionmentioning

confidence: 99%

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

Jin

et al. 2019

Exp Ther Med

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Since the introduction of therapeutic hypothermia (TH), trends have changed in the monitoring indicators used during and after cardiac arrest. During hypothermia, the cerebral metabolic rate of oxygen is reduced, which leads to uncertainty in regional cerebral tissue oxygen saturation (S ct O 2). The aim of the present study was to evaluate the effect of TH on changes in S ct O 2 using near-infrared spectroscopy. A total of 23 male domestic pigs were randomized into three groups: TH (n=9), normothermia (NT; n=9) and control (n=5). Animals in the control group underwent surgical preparation only. The animal models were established using 8 min of ventricular fibrillation and 5 min of cardiopulmonary resuscitation. In the TH group, at 5 min after resuscitation, the animals were cooled with a cooling blanket and ice packs for 24 h. S ct O 2 was recorded throughout the experiment. In all groups, The mean arterial pressure, arterial carbon dioxide partial pressure, arterial oxygen partial pressure, lactate, neuron-specific enolase (NSE) and S100B were measured at baseline and at 1, 3, 6, 12, 24 and 30 h after resuscitation. S ct O 2 significantly decreased after ventricular fibrillation, compared with the baseline. Following resuscitation, the S ct O 2 values gradually increased to 55.6±3.8% of baseline in the TH group and 51.2±3.5% in the NT group (P=0.039). Significant differences between the two groups were observed, starting at 6 h after cardiac arrest. Throughout the hypothermic period, NSE and S100B showed an increasing trend, then decreased during rewarming in the TH and NT groups. NSE and S100B showed greater improvement in the TH group compared with the NT group at 6 and 24 h after resuscitation. Following cardiac arrest, therapeutic hypothermia could increase S ct O 2 after resuscitation and could improve neurological outcome. In conclusion, S ct O 2 may be a feasible marker for use in the early assessment of brain damage during and after cardiac arrest.

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

Abstract: Near-infrared spectroscopy and rSO2 have been used as a monitor during CPR, detection of ROSC, after ROSC, and during post-resuscitation care. Prospective, controlled, randomized clinical studies are needed to document their wide use.

Cited by 10 publications

References 50 publications

Cerebral regional oxygen saturation during cardiopulmonary resuscitation and return of spontaneous circulation: A systematic review and meta-analysis

Cerebral regional oxygen saturation during cardiopulmonary resuscitation and return of spontaneous circulation: A systematic review and meta-analysis

Near-Infrared Spectroscopy Assessments of Regional Cerebral Oxygen Saturation for the Prediction of Clinical Outcomes in Patients With Cardiac Arrest: A Review of Clinical Impact, Evolution, and Future Directions

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

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