Temporal changes in peripheral regional oxygen saturation associated with return of spontaneous circulation after out-of-hospital cardiac arrest: A prospective observational cohort study in Japan.

AIM

Temporal changes in cerebral regional oxygen saturation (crSO) are useful for predicting return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA) patients. However, little is known regarding the usefulness of peripheral regional oxygen saturation (prSO) associated with OHCA patient outcomes. This study evaluated the association between temporal changes in prSO and ROSC in patients with OHCA.

METHODS

This was a prospective study at two tertiary emergency centres in Japan. We evaluated the relationship between ROSC and temporal changes in crSO and prSO. The rSO sensor was attached to the patient's forehead and upper arm, and rSO was continuously measured until resuscitative efforts were terminated or until the patient with sustained ROSC (>20 min) arrived at the emergency department.

RESULTS

We included 145 patients with OHCA, of whom 35 achieved ROSC. Witness status (odds ratio [95% confidence interval]: 11.6 [3.13-58.1]) and ΔprSO (1.13 [1.06-1.24]) were significantly associated with ROSC in multiple logistic analysis. In the ROSC group, ΔprSO increased earlier than ΔcrSO during cardiopulmonary resuscitation. In the non-ROSC group, there was no significant difference between ΔcrSO and ΔprSO, and neither increased before termination of resuscitation (TOR).

CONCLUSION

We demonstrated for the first time that prSO is associated with ROSC in OHCA patients and showed that temporal changes in prSO could predict ROSC earlier than those in crSO. Our findings could provide time to prepare early interventions after ROSC and assist in determining the TOR for OHCA patients in Japan. Further studies are needed to validate these findings.