Department of Emergency, Qinhuangdao First Hospital, Hebei Province, People's Republic of China.
PLoS One. 2020 Aug 28;15(8):e0234979. doi: 10.1371/journal.pone.0234979. eCollection 2020.
The present meta-analysis was based on the available studies to determine the potential role of the initial and regional cerebral oxygen saturation (rSO2) in monitoring the efficiency of cardiopulmonary resuscitation (CPR) and predicting the return of spontaneous circulation (ROSC). Three electronic databases of PubMed, Embase, and the Cochrane Library were searched to identify the studies that investigated the role of rSO2 on ROSC in CA patients throughout May 2018. The weighted mean difference (WMD) with 95% confidence interval (CI) was calculated to estimate the pooled effect using a random-effects model. Sensitivity, subgroup analyses, and publication bias were conducted. A total of 13 studies involving 678 CA patients (300 in-hospital (IH) patients, and 378 out-hospital (OH) patients) were included. The summary WMD suggested that ROSC patients were associated with higher initial rSO2 (WMD: 10.10%; 95% CI: 5.66-14.55; P<0.001) and mean rSO2 (WMD: 14.16%; 95% CI: 10.51-17.81; P<0.001) levels during CA and ROSC as compared to the non-ROSC. The results of meta-regression suggested that the male percentage and the location of cardiac arrest might bias the initial or mean rSO2 and the incidence of ROSC. These significant differences were observed in nearly all subsets. The findings of this study suggested that high initial or mean rSO2 levels were both associated with an increased incidence of ROSC in CA patients undergoing CPR. These correlations might be affected by the percentage of males or the location of cardiac arrest, thereby necessitating further large-scale studies to substantiate whether these correlations differ according to gender and the location of cardiac arrest.
本荟萃分析基于现有研究，旨在确定初始脑氧饱和度（rSO2）和区域性脑氧饱和度在监测心肺复苏（CPR）效率和预测自主循环恢复（ROSC）方面的潜在作用。通过检索 PubMed、Embase 和 Cochrane 图书馆三个电子数据库，确定了 2018 年 5 月以前调查 rSO2 对 CA 患者 ROSC 作用的研究。采用随机效应模型计算合并效应的加权均数差（WMD）及其 95%置信区间（CI）。进行敏感性分析、亚组分析和发表偏倚。共纳入 13 项研究，涉及 678 例 CA 患者（300 例院内（IH）患者，378 例院外（OH）患者）。汇总 WMD 提示 ROSC 患者初始 rSO2（WMD：10.10%；95%CI：5.66-14.55；P<0.001）和平均 rSO2（WMD：14.16%；95%CI：10.51-17.81；P<0.001）水平在 CA 和 ROSC 期间均高于非 ROSC 患者。元回归结果提示，男性比例和心搏骤停部位可能会影响初始或平均 rSO2 和 ROSC 发生率。这些显著差异几乎在所有亚组中都存在。本研究结果表明，CPR 期间 CA 患者初始或平均 rSO2 水平较高均与 ROSC 发生率增加相关。这些相关性可能受男性比例或心搏骤停部位的影响，因此需要进一步开展大规模研究，以确定这些相关性是否因性别和心搏骤停部位的不同而有所差异。
