Cerebral oximetry and return of spontaneous circulation after cardiac arrest: A systematic review and meta-analysis |
| |
| Institution: | 1. Cardiothoracic Intensive Care Unit, Intensive Care Directorate – St. Georges Healthcare NHS Trust, London SW17 0QT, United Kingdom;2. Department of Cardiothoracic Surgery, Oxford Heart Centre, Oxford University Hospitals, Oxford OX3 9DU, United Kingdom;3. Critical Care Research Group, University of Queensland and the Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD 4032, Australia;4. Department of Intensive Care Medicine, CHUV-Lausanne University Medical Center, CH-1011 Lausanne, Switzerland;5. Anaesthesia and Critical Care St. George''s Hospital and Medical School, London SW17 0QT, United Kingdom;1. Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus Medical Center, The Netherlands;2. Department of Public Health, Erasmus Medical Center, The Netherlands;1. Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA;2. Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark;3. Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA;4. Department of Anesthesia Critical Care, Beth Israel Deaconess Medical Center, Boston, MA, USA;5. Department of Emergency Medicine, Emory University School of Medicine, Rollins School of Public Health, Atlanta, GA, USA;6. Department of Medicine, Division of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA;1. Department of Cardiology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands;2. Section of Geriatrics, Department of Internal Medicine, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands;3. Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands;4. Department of Geriatrics, Gelre Hospitals, Postbus 9014, 7300 DS Apeldoorn, The Netherlands;1. Department of Emergency Medicine, The Catholic University of Korea, Republic of Korea;2. Department of Emergency Medicine, University of Pittsburgh School of Medicine, United States;1. North Central London School of Anaesthesia, Royal Free Hospital, London, United Kingdom;2. Barts and the London School of Anaesthesia, Royal London Hospital, London, United Kingdom |
| |
| Abstract: | AimThe 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.MethodsWe 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.ResultsA 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).ConclusionsHigher 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. |
| |
| Keywords: | Near infrared spectrometry Advanced cardiac life support Resuscitation order Cardiopulmonary resuscitation |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
