Turk J Med Sci. 2019 Feb 11;49(1):311-317. doi: 10.3906/sag-1809-165.
BACKGROUND/AIM: Some of the patients suffering from cardiac arrest (CA) remain in a chronic unconscious state in intensive care units (ICUs). The primary aim of this study was to evaluate the efficacy of chest compression (CC) on cerebral oxygenation during cardiopulmonary resuscitation (CPR). As a secondary goal, we attempted to determine the effects of regional cerebral oxygen saturation (rSO2) values on consciousness and the survival rate using the Full Outline of Unresponsiveness (FOUR) scoring method.
This observational preliminary study was carried out with 20 patients with CA who were hospitalized in ICUs. The rSO2 values measured by near-infrared spectroscopy were recorded during CA. FOUR scoring was used to determine the neurological status, severity of disease, and degree of organ dysfunction in survivors.
Return of spontaneous circulation (ROSC) was gained in 8 (40%) of 20 patients. Maximum rSO2 values were higher in survivors than in nonsurvivors (P = 0.005). The mean FOUR score before CA was 11.50 ± 0.8 in survivors, whereas this value was 7.87 ± 0.7 for 1 week after ROSC (P < 0.0001). There was a significant positive correlation between the minimum and mean rSO2 values and the mean 1-week FOUR scores in survivors (r = 0.811, r = 0.771 and P = 0.015, P = 0.025, respectively).
Our results suggest that the maximum rSO2 values affect ROSC while the minimum and mean rSO2 values affect the post-cardiac arrest neurological outcome.
背景/目的:一些患有心搏骤停(CA)的患者在重症监护病房(ICU)处于慢性无意识状态。本研究的主要目的是评估心肺复苏(CPR)期间胸外按压(CC)对脑氧合的效果。作为次要目标,我们试图使用全面昏迷反应评估量表(FOUR)评分法确定局部脑氧饱和度(rSO2)值对意识和存活率的影响。
这是一项在 ICU 住院的 20 例 CA 患者中进行的观察性初步研究。通过近红外光谱测量 rSO2 值,并在 CA 期间记录下来。使用 FOUR 评分来确定幸存者的神经状态、疾病严重程度和器官功能障碍程度。
20 例患者中有 8 例(40%)恢复自主循环(ROSC)。幸存者的最大 rSO2 值高于非幸存者(P = 0.005)。幸存者 CA 前的平均 FOUR 评分为 11.50 ± 0.8,而 ROSC 后 1 周的平均值为 7.87 ± 0.7(P < 0.0001)。幸存者中最小和平均 rSO2 值与平均 1 周 FOUR 评分之间存在显著正相关(r = 0.811,r = 0.771,P = 0.015,P = 0.025)。
我们的结果表明,最大 rSO2 值影响 ROSC,而最小和平均 rSO2 值影响心脏骤停后的神经预后。