Usefulness of a New Device to Monitor Cerebral Blood Oxygenation Using NIRS During Cardiopulmonary Resuscitation in Patients with Cardiac Arrest: A Pilot Study

Yagi, T.; Kawamorita, Tsuyoshi; Kuronuma, Keiichiro; Tachibana, Eizo; Watanabe, Kazuhiro; Chiba, Nobutaka; Ashida, Tadashi; Atsumi, Wataru; Kunimoto, Satoshi; Tani, Shigemasa; Matsumoto, Naoya; Okumura, Yasuo; Yoshino, Atsuo; Sakatani, Kaoru

doi:10.1007/978-3-030-34461-0_41

Cited by 10 publications

(6 citation statements)

References 13 publications

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“…Currently, there are several commercially available NIRS devices ( 12 , 16 , 34 , 36 , 42 – 45 ). These devices differ with regard to the wavelengths and frequencies used, the timing of light transmission, the distance between the light source and detector, and the primary principle of measurement [e.g., Beer-Lambert law ( 46 ), spatial-resolved spectroscopy law ( 47 ), or time-resolved absorption spectroscopy law ( 46 )].…”

Section: A Brief Review Of Nirs Technologymentioning

confidence: 99%

“…Measurements of rSO 2 are considered to reflect the balance between cerebral oxygen delivery and consumption in the area of the brain located beneath the device ( 7 ). NIRS has been applied in patients with circulatory shock ( 8 ), acute brain injury ( 9 , 10 ), those undergoing perioperative cardiac surgery ( 11 , 12 ) or carotid endarterectomy ( 13 – 15 ), and during veno-arterial extracorporeal membrane oxygenation in the intensive care unit (ICU) ( 16 – 18 ). Several recent studies have highlighted the feasibility of NIRS for brain monitoring during cardiopulmonary resuscitation (CPR) and after the return of spontaneous circulation (ROSC) in patients with CA ( 19 – 24 ).…”

Section: Introductionmentioning

confidence: 99%

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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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Section: A Brief Review Of Nirs Technologymentioning

confidence: 99%

Section: Introductionmentioning

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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“…Through the application of sensitivity analyses, meta-regression, and subgroup analyses to investigate the cause of heterogeneity, we learned that different NIRS devices calculate rScO 2 through different algorithms. The NIRO device calculates the tissue oxygenation index (TOI) through spatially resolved spectroscopy by the equation TOI = HbO 2 /(HbO 2 + HHb) × 100 ( 48 , 49 ). The INVOS device calculates rScO 2 according to the ratio of oxyhemoglobin to total hemoglobin ( 47 , 50 ).…”

Section: Discussionmentioning

confidence: 99%

Comparing near-infrared spectroscopy—measured cerebral oxygen saturation and corresponding venous oxygen saturations in children with congenital heart disease: a systematic review and meta-analysis

Ma¹,

Zhao²,

Wei³

et al. 2022

Transl Pediatr

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Background: Near-infrared spectroscopy (NIRS) is a non-invasive approach that measures cerebral regional oxygen saturation (rScO 2 ). In this study, we evaluated the evidence on the validity of NIRS and the interchangeability between NIRS and common invasive approaches by exploring the correlation and consistency and comparing the mean and standard deviation between the NIRS rScO 2 and jugular bulb venous oxygen saturation (SjvO 2 ) as well as central venous oxygen saturation (ScvO 2 ) in the perioperative period of children with congenital heart disease (CHD).Methods: We searched electronic bibliographic databases (PubMed, The Cochrane Library and Embase) and screened the studies that met the inclusion criteria. We included cross-sectional studies of CHD pediatric patients in the perioperative period receiving both tests for NIRS rScO 2 and SjvO 2 or NIRS rScO 2 and ScvO 2 . Methodological quality assessment and heterogeneity analyses were performed. We qualitatively summarized the results of Bland-Altman's analysis. Meta-regression, subgroup analyses, and sensitivity analyses were carried out to explore the causes of heterogeneity.Results: There was no significant difference in Cohen's d between rScO 2 and ScvO 2 or between rScO 2 and SjvO 2 (Cohen's d =0.06, 95% CI: −0.16 to 0.28; Cohen's d =0.03, 95% CI: −0.25 to 0.31, respectively) and notable heterogeneity existed (I 2 =76.0%, P<0.001; I 2 =73.6%, P<0.001, respectively). A positive linear correlation was present between rScO 2 and ScvO 2 or between rScO 2 and SjvO 2 (r=0.58, 95% CI: 0.54 to 0.63; r=0.60, 95% CI: 0.54 to 0.66, respectively) and the heterogeneity was not significant (I 2 =36.7%, P=0.065; I 2 =12.7%, P=0.328, respectively). In most studies, the 95% limits of agreements of Bland-Altman's analysis were large. No evidence of publication bias was observed. Conclusions:The rScO 2 measured by NIRS reflected the SjvO 2 and ScvO 2 monitored by invasive measurements in the perioperative period of children with CHD to some extent. However, wide limits of agreements between rScO 2 and SjvO 2 as well as ScvO 2 indicated that NIRS and SjvO 2 as well as ScvO 2 are not interchangeable. Whether NIRS plays a prominent role in monitoring cerebral oxygen saturation in children with CHD needs further research.

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“…Furthermore, design experts may be consulted to discuss how to optimise our adaptations to fit different patient body sizes. Last but not least, subsequent studies can be done to assess the efficacy of CPR in non-supine positions with respect to cerebral blood oxygenation via near-infrared spectroscopy 26 .…”

Section: Discussionmentioning

confidence: 99%

Shoulder strap fixation of LUCAS-2 to facilitate continuous CPR during non-supine (stair) stretcher transport of OHCAs patients

Chen

Chien

et al. 2021

Sci Rep

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Early recognition and rapid initiation of high-quality cardiopulmonary resuscitation (CPR) are key to maximising chances of achieving successful return of spontaneous circulation in patients with out-of-hospital cardiac arrests (OHCAs), as well as improving patient outcomes both inside and outside hospital. Mechanical chest compression devices such as the LUCAS-2 have been developed to assist rescuers in providing consistent, high-quality compressions, even during transportation. However, providing uninterrupted and effective compressions with LUCAS-2 during transportation down stairwells and in tight spaces in a non-supine position is relatively impossible. In this study, we proposed adaptations to the LUCAS-2 to allow its use during transportation down stairwells and examined its effectiveness in providing high-quality CPR to simulated OHCA patients. 20 volunteer emergency medical technicians were randomised into 10 pairs, each undergoing 2 simulation runs per experimental arm (LUCAS-2 versus control) with a loaded Resusci Anne First Aid full body manikin weighing 60 kg. Quality of CPR compressions performed was measured using the CPRmeter placed on the sternum of the manikin. The respective times taken for each phase of the simulation protocol were recorded. Fisher’s exact tests were used to analyse categorical variables and median test to analyse continuous variables. The LUCAS-2 group required a longer time (~ 35 s) to prepare the patient prior to transport (p < 0.0001) and arrive at the ambulance (p < 0.0001) compared to the control group. The CPR quality in terms of depth and rate for the overall resuscitation period did not differ significantly between the LUCAS-2 group and control group, though there was a reduction in both parameters when evaluating the device’s automated compressions during transport. Nevertheless, the application of the LUCAS-2 device yielded a significantly higher chest compression fraction of 0.76 (p < 0.0001). Our novel adaptations to the LUCAS-2 device allow for uninterrupted compressions in patients being transported down stairwells, thus yielding better chest compression fractions for the overall resuscitation period. Whether potentially improved post-OHCA survival rates may be achieved requires confirmation in a real-world scenario study.

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Usefulness of a New Device to Monitor Cerebral Blood Oxygenation Using NIRS During Cardiopulmonary Resuscitation in Patients with Cardiac Arrest: A Pilot Study

Cited by 10 publications

References 13 publications

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

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

Comparing near-infrared spectroscopy—measured cerebral oxygen saturation and corresponding venous oxygen saturations in children with congenital heart disease: a systematic review and meta-analysis

Shoulder strap fixation of LUCAS-2 to facilitate continuous CPR during non-supine (stair) stretcher transport of OHCAs patients

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