小儿心脏骤停心肺复苏期间的近红外光谱：一项前瞻性观察研究。
Near-infrared spectroscopy during cardiopulmonary resuscitation for pediatric cardiac arrest: A prospective, observational study.
作者信息
Francoeur C, Landis W P, Winters M, Naim M Y, Donoghue A, Dominick C L, Huh J W, MacDonald J M, Lang S S, Yuan I, Berg R A, Nadkarni V M, Kilbaugh T J, Sutton R M, Kirschen M P, Morgan R W, Topjian A A
机构信息
Department of Pediatrics, CHU de Québec - Université Laval Research Center, Quebec, Canada.
Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
出版信息
Resuscitation. 2022 May;174:35-41. doi: 10.1016/j.resuscitation.2022.03.014. Epub 2022 Mar 18.
AIM
Cerebral oxygenation (rSO2) is not routinely measured during pediatric cardiopulmonary resuscitation (CPR). We aimed to determine whether higher intra-arrest rSO2 was associated with return of spontaneous circulation (ROSC) and survival to hospital discharge.
METHODS
Prospective, single-center observational study of cerebral oximetry using near-infrared spectroscopy (NIRS) during pediatric cardiac arrest from 2016 to 2020. Eligible patients had ≥30 s of rSO2 data recorded during CPR. We compared median rSO2 and percentage of rSO2 measurements above a priori thresholds for the entire event and the final five minutes of the CPR event between patients with and without ROSC and survival to discharge.
RESULTS
Twenty-one patients with 23 CPR events were analyzed. ROSC was achieved in 17/23 (73.9%) events and five/21 (23.8%) patients survived to discharge. The median rSO2 was higher for events with ROSC vs. no ROSC for the overall event (62% [56%, 70%] vs. 45% [35%, 51%], p = 0.025) and for the final 5 minutes of the event (66% [55%, 72%] vs. 43% [35%, 44%], p = 0.01). Patients with ROSC had a higher percentage of measurements above 50% during the final five minutes of CPR (100% [100%, 100%] vs. 0% [0%, 29%], p = 0.01). There was no association between rSO2 and survival to discharge.
CONCLUSIONS
Higher cerebral rSO2 during CPR for pediatric cardiac arrest was associated with higher rates of ROSC but not with survival to discharge.
目的
小儿心肺复苏（CPR）期间通常不常规测量脑氧合（rSO2）。我们旨在确定较高的心脏骤停期间rSO2是否与自主循环恢复（ROSC）及存活至出院相关。
方法
对2016年至2020年小儿心脏骤停期间使用近红外光谱（NIRS）进行脑氧饱和度测定的前瞻性单中心观察性研究。符合条件的患者在CPR期间有≥30秒的rSO2数据记录。我们比较了有ROSC和无ROSC以及存活至出院的患者在整个事件及CPR事件最后五分钟内的rSO2中位数和高于先验阈值的rSO2测量百分比。
结果
分析了21例患者的23次CPR事件。17/23（73.9%）次事件实现了ROSC，5/21（23.8%）例患者存活至出院。对于整个事件，有ROSC的事件与无ROSC的事件相比，rSO2中位数更高（62%[56%，70%]对45%[35%，51%]，p = 0.025），对于事件的最后五分钟也是如此（66%[55%，72%]对43%[35%，44%]，p = 0.01）。在CPR最后五分钟内，有ROSC的患者测量值高于50%的百分比更高（100%[100%，100%]对0%[0%，29%]，p = 0.01）。rSO2与存活至出院之间无关联。
结论
小儿心脏骤停CPR期间较高的脑rSO2与较高的ROSC率相关，但与存活至出院无关。
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