Near-infrared spectroscopy after out-of-hospital cardiac arrest

Autor: Pekka Jakkula, Johanna Hästbacka, Matti Reinikainen, Ville Pettilä, Pekka Loisa, Marjaana Tiainen, Erika Wilkman, Stepani Bendel, Thomas Birkelund, Anni Pulkkinen, Minna Bäcklund, Sirkku Heino, Sari Karlsson, Hiski Kopponen, Markus B. Skrifvars
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Critical Care, Vol 23, Iss 1, Pp 1-8 (2019)
Druh dokumentu: article
ISSN: 1364-8535
DOI: 10.1186/s13054-019-2428-3
Popis: Abstract Background Cerebral hypoperfusion may aggravate neurological damage after cardiac arrest. Near-infrared spectroscopy (NIRS) provides information on cerebral oxygenation but its relevance during post-resuscitation care is undefined. We investigated whether cerebral oxygen saturation (rSO2) measured with NIRS correlates with the serum concentration of neuron-specific enolase (NSE), a marker of neurological injury, and with clinical outcome in out-of-hospital cardiac arrest (OHCA) patients. Methods We performed a post hoc analysis of a randomised clinical trial (COMACARE, NCT02698917) comparing two different levels of carbon dioxide, oxygen and arterial pressure after resuscitation from OHCA with ventricular fibrillation as the initial rhythm. We measured rSO2 in 118 OHCA patients with NIRS during the first 36 h of intensive care. We determined the NSE concentrations from serum samples at 48 h after cardiac arrest and assessed neurological outcome with the Cerebral Performance Category (CPC) scale at 6 months. We evaluated the association between rSO2 and serum NSE concentrations and the association between rSO2 and good (CPC 1–2) and poor (CPC 3–5) neurological outcome. Results The median (inter-quartile range (IQR)) NSE concentration at 48 h was 17.5 (13.4–25.0) μg/l in patients with good neurological outcome and 35.2 (22.6–95.8) μg/l in those with poor outcome, p
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