Characteristics of jugular bulb oxygen saturation in patients after cardiac arrest: A prospective study

Autor:	Sten Rubertsson, Marja-Leena Kristofferzon, Ing-Marie Larsson, Ivan Rosenqvist, Ewa Wallin, Johanna Nordmark-Grass
Rok vydání:	2018
Předmět:	Male Resuscitation Critical Care 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Intensive care Humans Medicine In patient Oximetry Prospective Studies Coma Prospective cohort study Oxygen content Aged Aged 80 and over Brain Chemistry business.industry 030208 emergency & critical care medicine Small sample General Medicine Middle Aged Prognosis Heart Arrest Oxygen Catheter Treatment Outcome Anesthesiology and Pain Medicine Anesthesia Female Jugular Veins Nervous System Diseases Jugular bulb oxygen saturation business
Zdroj:	Acta Anaesthesiologica Scandinavica. 62:1237-1245
ISSN:	0001-5172
Popis:	Background Using cerebral oxygen venous saturation post-cardiac arrest (CA) is limited because of a small sample size and prior to establishment of target temperature management (TTM). We aimed to describe variations in jugular bulb oxygen saturation during intensive care in relation to neurological outcome at 6 months post- CA in cases where TTM 33°C was applied. Method Prospective observational study in patients over 18 years, comatose immediately after resuscitation from CA. Patients were treated with TTM 33°C M and received a jugular bulb catheter within the first 26 hours post-CA. Neurological outcome was assessed at 6 months using the Cerebral Performance Categories (CPC) and dichotomized into good (CPC 1-2) and poor outcome (CPC 3-5). Results Seventy-five patients were included and 37 (49%) patients survived with a good outcome at 6 months post-CA. No differences were found between patients with good outcome and poor outcome in jugular bulb oxygen saturation. Higher values were seen in differences in oxygen content between central venous oxygen saturation and jugular bulb oxygen saturation in patients with good outcome compared to patients with poor outcome at 6 hours (12 [8-21] vs 5 [-0.3 to 11]% P = .001) post-CA. Oxygen extraction fraction from the brain illustrated lower values in patients with poor outcome compared to patients with good outcome at 96 hours (14 [9-23] vs 31 [25-34]% P = .008). Conclusions Oxygen delivery and extraction differed in patients with a good outcome compared to those with a poor outcome at single time points. Based on the present findings, the usefulness of jugular bulb oxygen saturation for prognostic purposes is uncertain in patients treated with TTM 33°C post-CA.
Databáze:	OpenAIRE
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