Skeletal muscle oxygenation during cardiopulmonary resuscitation as a predictor of return of spontaneous circulation: a pilot study

Miha Košir; Hugon Možina; Matej Podbregar

doi:10.1186/s40001-023-01393-z

Skeletal muscle oxygenation during cardiopulmonary resuscitation as a predictor of return of spontaneous circulation: a pilot study

Eur J Med Res. 2023 Oct 11;28(1):418. doi: 10.1186/s40001-023-01393-z.

Authors

Miha Košir^{1

2}, Hugon Možina^{1

3}, Matej Podbregar^{4

5}

Affiliations

¹ Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000, Ljubljana, Slovenia.
² Unit SNMP, Community Health Centre Ljubljana, Bohoričeva Ulica 4, 1000, Ljubljana, Slovenia.
³ Emergency Department, University Medical Center Ljubljana, Zaloška Cesta 4, 1000, Ljubljana, Slovenia.
⁴ Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000, Ljubljana, Slovenia. matej.podbregar@guest.arnes.si.
⁵ Department for Internal Intensive Care, General Hospital Celje, Oblakova Ulica 5, 3000, Celje, Slovenia. matej.podbregar@guest.arnes.si.

Abstract

Background: Near-infrared spectroscopy (NIRS) provides regional tissue oxygenation (rSO₂) even in pulseless states, such as out-of-hospital cardiac arrest (OHCA). Brain rSO₂ seems to be important predictor of return of spontaneous circulation (ROSC) during cardiopulmonary resuscitation (CPR). Aim of our study was to explore feasibility for monitoring and detecting changes of skeletal muscle rSO₂ during resuscitation.

Methods: Skeletal muscle and brain rSO₂ were measured by NIRS (SenSmart Model X-100, Nonin, USA) during CPR in adult patient with OHCA. Start (basal) rSO₂, maximal during CPR (maximal) and difference between maximal-minimal rSO₂ (delta-rSO₂), were recorded. Patients were divided into ROSC and NO-ROSC group.

Results: 20 patients [age: 66.0ys (60.5-79.5), 65% male] with OHCA [50% witnessed, 70% BLS, time to ALS 13.5 min (11.0-19.0)] were finally analyzed. ROSC was confirmed in 5 (25%) patients. Basal and maximal skeletal muscle rSO₂ were higher in ROSC compared to NO-ROSC group [49.0% (39.7-53.7) vs. 15.0% (12.0-25.2), P = 0.006; 76.0% (52.7-80.5) vs. 34.0% (18.0-49.5), P = 0.005, respectively]. There was non-linear cubic relationship between time of collapse and basal skeletal muscle rSO₂ in witnessed OHCA and without BLS (F-ratio = 9.7713, P = 0.0261). There was correlation between maximal skeletal muscle and brain rSO₂ (n = 18, rho: 0.578, P = 0.0121).

Conclusions: Recording of skeletal muscle rSO₂ during CPR in patients with OHCA is feasible. Basal and maximal skeletal muscle rSO₂ were higher in ROSC compared to NO-ROSC group. Clinical trial registration number ClinicalTrials.gov, NCT04058925, registered on: 16th August 2019. URL of trial registry record: https://www.

Clinicaltrials: gov/ct2/show/NCT04058925?titles=Tissue+Oxygenation+During+Cardiopulmonary+Resuscitation+as+a+Predictor+of+Return+of+Spontaneous+Circulation&draw=2&rank=1 .

Keywords: Brain, cardiac arrest; Near-infrared spectroscopy; Return of spontaneous circulation; Skeletal muscle; Tissue oxygenation.

MeSH terms

Adult
Aged
Cardiopulmonary Resuscitation* / methods
Cerebrovascular Circulation / physiology
Female
Humans
Male
Out-of-Hospital Cardiac Arrest* / therapy
Pilot Projects
Return of Spontaneous Circulation

Associated data

ClinicalTrials.gov/NCT04058925