The relationship between cerebral regional oxygen saturation during extracorporeal cardiopulmonary resuscitation and the neurological outcome in a retrospective analysis of 16 cases

摘要

BackgroundIn recent years, the measurement of cerebral regional oxygen saturation (rSO₂) during resuscitation has attracted attention. The objective of this study was to clarify the relationship between the serial changes in the cerebral rSO₂ values during extracorporeal cardiopulmonary resuscitation (ECPR) and the neurological outcome. MethodsWe measured the serial changes in the cerebral rSO₂ values of patients with out-of-hospital cardiac arrest before and after ECPR in Osaka National Hospital. ResultsFrom January 2013 through March 2015, the serial changes in the cerebral rSO₂ values were evaluated in 16 patients. Their outcomes, as measured by the Glasgow Outcome Scale (GOS) score at discharge, included good recovery (GR) ( n =?4), vegetative state (VS) ( n =?2), and death (D) ( n =?10). In the poor neurological group (VS and D: n =?12; age, 52.8?±?4.0?years), the cerebral rSO₂ values showed a significant increase during ECPR (5?min before ECPR: 52.0?±?1.8%; 2?min before ECPR: 56.1?±?2.3%; 2?min after ECPR: 63.5?±?2.2%; 5?min after ECPR: 66.4?±?2.2%; 10?min after ECPR: 67.6?±?2.3% [ P n =?4; age, 53.8?±?6.9?years), the cerebral rSO₂ values did not increase to a significant extent during ECPR (5?min before ECPR: 61.9?±?3.1%; 2?min before ECPR: 57.1?±?4.0%; 2?min after ECPR: 59.6?±?3.8%; 5?min after ECPR: 61.0?±?3.7%; 10?min after ECPR: 62.0?±?3.8% [ P =?0.88]). Our study suggested that the patients whose cerebral rSO₂ values showed no significant improvement after ECPR might have had a good neurological prognosis. ConclusionsThe serial changes in the cerebral rSO₂ values during ECPR may predict a patient’s neurological outcome. The further evaluation of the validity of rSO₂ monitoring during ECPR may lead to a new resuscitation strategy.