The need for comprehensive NIRS-measurement from on-scene treatment to post-ROSC phase

摘要

To the Editor, With great interest we studied the recent publication by Takegawa et al.1 discussing their experiences with cerebral regional oxygen saturation (rSO2) during cardiopulmonary resuscitation (CPR). Near-infrared-spectroscopy (NIRS) is an innovative technology in prognostication-and probably also therapeutic guidance-for medical teams assessing patients having a cardiac arrest (CA). However, due to variable and conflicting reports in the past2 this new tool is partly seen with scepticism. In front of this background, in our opinion it is imperative to act cautiously and only produce well-defined conclusions-therefore, we would like to make a few comments. The authors incorrectly state that "the potential for assessing the trend of the rSO2 value has not been discussed when determining the probability of return of spontaneous circulation (ROSC)”, since obtaining not punctual but dynamic rSO2 values for prognostication during CA has been a common opinion in literature for quite some time. Moreover, their findings' novelty is stressed-but we have previously reported that delta rSO2-levels during CPR can predict ROSC and favourable neurological outcome, and even suggested respective thresholds.