Is cerebral oxygen saturation an effective method to terminate or continue cardiopulmonary resuscitation in pediatric patients

Objective: Near infrared spectroscopy (NIRS) is a new technology for monitoring of cardiopulmonary resuscitation (CPR). The useof NIRS has advantages to monitoring cerebral oxygenation in the cardiac arrest patients. In this prospective study, the efficacy of theNIRS device on the determination of ROSC or futility of CPR was investigated in pediatric out-of-hospital cardiac arrest patients inthe emergency department.Methods: All the out-of-hospital cardiac arrest patients who admitted to our pediatric emergency department were included in thisprospective study. All patients were monitored via NIRS besides standard monitoring during CPR. Cardiopulmonary resuscitationwas performed accordingly Pediatric Advanced Life Support 2010 guideline.Results: 10 patients were included to this study. The median (IQR) age of patients was 40.0 (14.0-88.2) months. Three (30%) of 10patients had been achieved sustained ROSC. Abruptly increments in cerebral regional oxygen saturation (CrSO2) were observed inall these three patients. Minimum values of the CrSO2 were significantly higher and the percentages of the median times under the30% of CrSO2 were significantly lower in the ROSC group (p=0.02, p=0.02).Conclusions: Our study indicated that low CrSO2 value can be a predictive factor for futility of CPR. Additionally, abruptly incrementof CrSO2 during CPR can be an indicator for ROSC but on-going high level of CrSO2 values should be maintain for sustained ROSC.