Journal article
Cerebral oximetry and return of spontaneous circulation after cardiac arrest: A systematic review and meta-analysis.
- Sanfilippo F Cardiothoracic Intensive Care Unit, Intensive Care Directorate - St. Georges Healthcare NHS Trust, London SW17 0QT, United Kingdom. Electronic address: filipposanfi@yahoo.it.
- Serena G Cardiothoracic Intensive Care Unit, Intensive Care Directorate - St. Georges Healthcare NHS Trust, London SW17 0QT, United Kingdom.
- Corredor C Cardiothoracic Intensive Care Unit, Intensive Care Directorate - St. Georges Healthcare NHS Trust, London SW17 0QT, United Kingdom.
- Benedetto U Department of Cardiothoracic Surgery, Oxford Heart Centre, Oxford University Hospitals, Oxford OX3 9DU, United Kingdom.
- Maybauer MO Critical Care Research Group, University of Queensland and the Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD 4032, Australia.
- Al-Subaie N Cardiothoracic Intensive Care Unit, Intensive Care Directorate - St. Georges Healthcare NHS Trust, London SW17 0QT, United Kingdom.
- Madden B Cardiothoracic Intensive Care Unit, Intensive Care Directorate - St. Georges Healthcare NHS Trust, London SW17 0QT, United Kingdom.
- Oddo M Department of Intensive Care Medicine, CHUV-Lausanne University Medical Center, CH-1011 Lausanne, Switzerland.
- Cecconi M Anaesthesia and Critical Care St. George's Hospital and Medical School, London SW17 0QT, United Kingdom.
- 2015-07-11
Published in:
- Resuscitation. - 2015
Advanced cardiac life support
Cardiopulmonary resuscitation
Near infrared spectrometry
Resuscitation order
Cardiopulmonary Resuscitation
Cerebrovascular Circulation
Humans
Out-of-Hospital Cardiac Arrest
Oximetry
Recovery of Function
English
AIM
The prediction of return of spontaneous circulation (ROSC) during resuscitation of patients suffering of cardiac arrest (CA) is particularly challenging. Regional cerebral oxygen saturation (rSO2) monitoring through near-infrared spectrometry is feasible during CA and could provide guidance during resuscitation.
METHODS
We conducted a systematic review and meta-analysis on the value of rSO2 in predicting ROSC both after in-hospital (IH) or out-of-hospital (OH) CA. Our search included MEDLINE (PubMed) and EMBASE, from inception until April 4th, 2015. We included studies reporting values of rSO2 at the beginning of and/or during resuscitation, according to the achievement of ROSC.
RESULTS
A total of nine studies with 315 patients (119 achieving ROSC, 37.7%) were included in the meta-analysis. The majority of those patients had an OHCA (n=225, 71.5%; IHCA: n=90, 28.5%). There was a significant association between higher values of rSO2 and ROSC, both in the overall calculation (standardized mean difference, SMD -1.03; 95%CI -1.39,-0.67; p<0.001), and in the subgroups analyses (rSO2 at the beginning of resuscitation: SMD -0.79; 95%CI -1.29,-0.30; p=0.002; averaged rSO2 value during resuscitation: SMD -1.28; 95%CI -1.74,-0.83; p<0.001).
CONCLUSIONS
Higher initial and average regional cerebral oxygen saturation values are both associated with greater chances of achieving ROSC in patients suffering of CA. A note of caution should be made in interpreting these results due to the small number of patients and the heterogeneity in study design: larger studies are needed to clinically validate cut-offs for guiding cardiopulmonary resuscitation.
The prediction of return of spontaneous circulation (ROSC) during resuscitation of patients suffering of cardiac arrest (CA) is particularly challenging. Regional cerebral oxygen saturation (rSO2) monitoring through near-infrared spectrometry is feasible during CA and could provide guidance during resuscitation.
METHODS
We conducted a systematic review and meta-analysis on the value of rSO2 in predicting ROSC both after in-hospital (IH) or out-of-hospital (OH) CA. Our search included MEDLINE (PubMed) and EMBASE, from inception until April 4th, 2015. We included studies reporting values of rSO2 at the beginning of and/or during resuscitation, according to the achievement of ROSC.
RESULTS
A total of nine studies with 315 patients (119 achieving ROSC, 37.7%) were included in the meta-analysis. The majority of those patients had an OHCA (n=225, 71.5%; IHCA: n=90, 28.5%). There was a significant association between higher values of rSO2 and ROSC, both in the overall calculation (standardized mean difference, SMD -1.03; 95%CI -1.39,-0.67; p<0.001), and in the subgroups analyses (rSO2 at the beginning of resuscitation: SMD -0.79; 95%CI -1.29,-0.30; p=0.002; averaged rSO2 value during resuscitation: SMD -1.28; 95%CI -1.74,-0.83; p<0.001).
CONCLUSIONS
Higher initial and average regional cerebral oxygen saturation values are both associated with greater chances of achieving ROSC in patients suffering of CA. A note of caution should be made in interpreting these results due to the small number of patients and the heterogeneity in study design: larger studies are needed to clinically validate cut-offs for guiding cardiopulmonary resuscitation.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.resuscitation.2015.06.023
- PMID 26159613
- Persistent URL
- https://sonar.ch/global/documents/78696
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