1. Near-infrared spectroscopy after out-of-hospital cardiac arrest
- Author
-
Stepani Bendel, Anni Pulkkinen, Sirkku Heino, Thomas Birkelund, Marjaana Tiainen, Minna Bäcklund, Sari Karlsson, Johanna Hästbacka, Matti Reinikainen, Hiski Kopponen, Markus B. Skrifvars, Pekka Loisa, Pekka Jakkula, Ville Pettilä, Erika Wilkman, HUS Perioperative, Intensive Care and Pain Medicine, Anestesiologian yksikkö, Clinicum, University of Helsinki, Department of Diagnostics and Therapeutics, HYKS erva, Päijät-Häme Welfare Consortium, Neurologian yksikkö, HUS Neurocenter, and HUS Emergency Medicine and Services
- Subjects
Male ,Resuscitation ,Cerebral oxygen saturation ,CEREBRAL OXYGEN-SATURATION ,Critical Care and Intensive Care Medicine ,OXIMETRY ,0302 clinical medicine ,Prospective Studies ,Spectroscopy, Near-Infrared ,RESUSCITATION ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,Middle Aged ,Prognosis ,Cardiac arrest ,3. Good health ,Perfusion ,Ventricular Fibrillation ,Cardiology ,Female ,Hypoxic ischemic encephalopathy ,Adult ,medicine.medical_specialty ,Statistics, Nonparametric ,03 medical and health sciences ,Internal medicine ,Intensive care ,Post-hoc analysis ,medicine ,Humans ,Arterial Pressure ,Cerebrum ,Aged ,Chi-Square Distribution ,business.industry ,Research ,030208 emergency & critical care medicine ,lcsh:RC86-88.9 ,Odds ratio ,Carbon Dioxide ,3126 Surgery, anesthesiology, intensive care, radiology ,Neuron-specific enolase (NSE) ,medicine.disease ,Survival Analysis ,Confidence interval ,Oxygen ,Blood pressure ,Phosphopyruvate Hydratase ,Cerebral oxygenation ,Ventricular fibrillation ,business ,Biomarkers ,Out-of-Hospital Cardiac Arrest - 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
- Published
- 2019
- Full Text
- View/download PDF