Effect of regional cerebral oximetry to estimate neurologic prognostic outcomes in patients administered targeted temperature management

Am J Emerg Med. 2018 Dec;36(12):2236-2241. doi: 10.1016/j.ajem.2018.04.016. Epub 2018 Apr 9.

Abstract

Purpose: The aim of our study is to research the role and efficacy of cerebral oximetry in predicting neurologic prognosis when applied during TTM to patients experiencing coma after CA.

Methods: This study was performed on surviving adult comatose patients after CA treated with TTM. The average scores of rSO2 was measured at 6h intervals for the first 2days and once a day for the following 3days with a NIRS device during TTM. The CPC scale was used to define the neurologic outcomes of patients. We compared the correlations of rSO2 values between good (CPC 1-2) and poor (CPC 3-5) neurologic outcomes in CA patients.

Results: There was no statistically significant difference identified between the prognosis groups in terms of rSO2, CPR durations, hemoglobin values and admission body temperature (p>0.05). When the variation in rSO2 values over time is investigated, though there was no significant difference between the good and poor prognosis groups, it appeared to fall in the first 6h in both prognosis groups. The median NT-proBNP and lactate values were observed to be higher in the poor prognosis group.

Conclusion: There is no significant correlation between rSO2 values and neurologic outcomes. Multimodal monitoring methods may be useful and further studies with a larger patient population are necessary in this area.

Keywords: Cerebral oximetry; Neurologic outcome; Target temperature management.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Brain / metabolism*
  • Cardiopulmonary Resuscitation
  • Female
  • Heart Arrest / metabolism
  • Heart Arrest / therapy*
  • Humans
  • Hypothermia, Induced*
  • Lactic Acid / metabolism
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / metabolism
  • Oximetry*
  • Oxygen / metabolism*
  • Oxygen Consumption*
  • Peptide Fragments / metabolism
  • Prognosis
  • Prospective Studies
  • ROC Curve
  • Spectroscopy, Near-Infrared

Substances

  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • Lactic Acid
  • Oxygen