The prognostic value of cerebral oxygen saturation measurement for assessing prognosis after cardiopulmonary resuscitation

• Published in: Brazilian journal of anesthesiology (Elsevier) 2017-07, Vol.67 (4), p.355-361
• Main Authors: Inal, Mehmet Turan, Memiş, Dilek, Yıldırım, Ilker, Uğur, Hüseyin, Erkaymaz, Aysegul, Turan, F. Nesrin
• Format: Article
• Language: eng ; por
• Subjects: Adult; Aged; Aged, 80 and over; ANESTHESIOLOGY; Brain - metabolism; Cardiopulmonary Resuscitation; Cerebral oxygen saturation; Female; Humans; Male; Middle Aged; Oximetry; Oxygen Consumption; Prognosis; Prognóstico; Reanimação cardiopulmonar; Retrospective Studies; Saturação de oxigênio cerebral; Young Adult
• ISSN: 0104-0014; 1806-907X; 0104-0014; 1806-907X
• DOI: 10.1016/j.bjane.2016.07.016

Despite new improvements on cardiopulmonary resuscitation (CPR), brain damage is very often after resuscitation. To assess the prognostic value of cerebral oxygen saturation measurement (rSO2) for assessing prognosis on patients after cardiopulmonary resuscitation. Retrospective analysis. We analyzed 25 post-CPR patients (12 female and 13 male). All the patients were cooled to a target temperature of 33–34°C. The Glascow Coma Scale (GCS), Corneal Reflexes (CR), Pupillary Reflexes (PR), arterial Base Excess (BE) and rSO2 measurements were taken on admission. The rewarming GCS, CR, PR, BE and rSO2 measurements were made after the patient's temperature reached 36°C. In survivors, the baseline rSO2 value was 67.5 (46–70) and the percent difference between baseline and rewarming rSO2 value was 0.03 (0.014–0.435). In non-survivors, the baseline rSO2 value was 30 (25–65) and the percent difference between baseline and rewarming rSO2 value was 0.031 (−0.08 to −20). No statistical difference was detected on percent changes between baseline and rewarming values of rSO2. Statistically significant difference was detected between baseline and rewarming GCS groups (p=0.004). No statistical difference was detected between GCS, CR, PR, BE and rSO2 to determine the prognosis. Despite higher values of rSO2 on survivors than non-survivors, we found no statistically considerable difference between groups on baseline and the rewarming rSO2 values. Since the measurement is simple, and not affected by hypotension and hypothermia, the rSO2 may be a useful predictor for determining the prognosis after CPR. Apesar dos novos avanços em reanimação cardiopulmonar (RCP), o dano cerebral muitas vezes ocorre após a reanimação. Avaliar o valor prognóstico de medir a saturação de oxigênio cerebral (rSO2) para estimar o prognóstico em pacientes após a reanimação cardiopulmonar. Análise retrospectiva. Foram avaliados após RCP 25 pacientes (12 do sexo feminino e 13 do masculino). Todos os pacientes foram submetidos à hipotermia (temperatura alvo de 33-34°C). As mensurações da Escala de Coma de Glascow (GCS), dos reflexos corneanos (RC), dos reflexos pupilares (RP), e do excesso de base (EB) e rSO2 foram feitas na admissão. Na hipertermia, as mensurações de GCS, RC, RP, EB e rSO2 foram feitas depois que a temperatura atingiu 36°C. Em sobreviventes, o valor basal de rSO2 foi de 67,5 (46-70) e a diferença percentual entre o valor basal e a hipertermia de rSO2 foi de 0,03 (0,014-0,435). Em não so