Cerebral Oximetry during Out-of-Hospital Resuscitation: Pilot Study of First Responder Implementation.

Autor:	Shin J; Received February 22, 2021 from Emergency Medical Services Division of Public Health, Seattle & King County, Seattle, WA (JS, JB, PK, TR); Stryker, Redmond, WA (RW, FC); Nonin Medical, Inc, Plymouth, MN (JC); Department of Medicine, University of Washington, Seattle, WA (PK, TR). Revised received June 8, 2021; accepted for publication June 21, 2021., Walker R; Received February 22, 2021 from Emergency Medical Services Division of Public Health, Seattle & King County, Seattle, WA (JS, JB, PK, TR); Stryker, Redmond, WA (RW, FC); Nonin Medical, Inc, Plymouth, MN (JC); Department of Medicine, University of Washington, Seattle, WA (PK, TR). Revised received June 8, 2021; accepted for publication June 21, 2021., Blackwood J; Received February 22, 2021 from Emergency Medical Services Division of Public Health, Seattle & King County, Seattle, WA (JS, JB, PK, TR); Stryker, Redmond, WA (RW, FC); Nonin Medical, Inc, Plymouth, MN (JC); Department of Medicine, University of Washington, Seattle, WA (PK, TR). Revised received June 8, 2021; accepted for publication June 21, 2021., Chapman F; Received February 22, 2021 from Emergency Medical Services Division of Public Health, Seattle & King County, Seattle, WA (JS, JB, PK, TR); Stryker, Redmond, WA (RW, FC); Nonin Medical, Inc, Plymouth, MN (JC); Department of Medicine, University of Washington, Seattle, WA (PK, TR). Revised received June 8, 2021; accepted for publication June 21, 2021., Crackel J; Received February 22, 2021 from Emergency Medical Services Division of Public Health, Seattle & King County, Seattle, WA (JS, JB, PK, TR); Stryker, Redmond, WA (RW, FC); Nonin Medical, Inc, Plymouth, MN (JC); Department of Medicine, University of Washington, Seattle, WA (PK, TR). Revised received June 8, 2021; accepted for publication June 21, 2021., Kudenchuk P; Received February 22, 2021 from Emergency Medical Services Division of Public Health, Seattle & King County, Seattle, WA (JS, JB, PK, TR); Stryker, Redmond, WA (RW, FC); Nonin Medical, Inc, Plymouth, MN (JC); Department of Medicine, University of Washington, Seattle, WA (PK, TR). Revised received June 8, 2021; accepted for publication June 21, 2021., Rea T; Received February 22, 2021 from Emergency Medical Services Division of Public Health, Seattle & King County, Seattle, WA (JS, JB, PK, TR); Stryker, Redmond, WA (RW, FC); Nonin Medical, Inc, Plymouth, MN (JC); Department of Medicine, University of Washington, Seattle, WA (PK, TR). Revised received June 8, 2021; accepted for publication June 21, 2021.
Jazyk:	angličtina
Zdroj:	Prehospital emergency care [Prehosp Emerg Care] 2022 Jul-Aug; Vol. 26 (4), pp. 519-523. Date of Electronic Publication: 2021 Jul 27.
DOI:	10.1080/10903127.2021.1948647
Abstrakt:	Background: Anoxic brain injury is a common mode of death following out-of-hospital cardiac arrest (OHCA). We assessed the course of regional cerebral oxygen saturation (rSO 2 ) at the outset and during first responder resuscitation to understand its relationship with return of spontaneous circulation (ROSC) and functional survival. Methods: We undertook a prospective observational investigation of adult OHCA patients treated by a first-responder EMS agency in King County, WA. Cerebral oximetry was performed using the SenSmart® Model X-100 Universal Oximetry System (Nonin Medical, Inc). We determined cerebral oximetry rSO 2 overall and stratified according to ROSC and favorable survival status defined by Cerebral Performance Category (CPC) of 1-2. Results: Among the 59 OHCA cases enrolled, 47% ( n  = 28) achieved ROSC and 14% ( n  = 8) survived with CPC 1-2. On average, initial rSO 2 cerebral oximetry was 41% and was not different at the outset according to return of spontaneous circulation (ROSC) or survival status. Within 5 minutes of first responder resuscitation, those who would subsequently achieve ROSC had a higher rSO 2 than those who would not achieve ROSC (51% vs. 43%, p  = 0.03). Among patients who achieved ROSC, those who would survive with CPC 1-2 had a higher rSO 2 cerebral oximetry following ROSC than nonsurvivors (74% vs. 60%, p  = 0.04 at 5 minutes post ROSC), a difference that was not evident in the minutes prior to ROSC (55% vs. 51% at 3 minutes prior to ROSC, p  = 0.5). Conclusion: In this observational study, where first responders applied cerebral oximetry, higher rSO 2 during the course of care predicted ROSC among all patients and predicted favorable survival among those who achieved ROSC. Future investigation should evaluate whether and how treatments might modify rSO 2 and in turn may influence prognosis.
Databáze:	MEDLINE
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