Matsuyama Tasuku, Yasutake Yuki, Inaba Daichi, Yoshihara Hideaki, Bando Keisuke, Matsui Toshihisa, Nagama Masaki, Kano Hitoshi
Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
Emergency and Critical Care Center, Kagoshima City Hospital, Kagoshima 890-8760, Japan.
J Clin Med. 2022 Apr 4;11(7):2018. doi: 10.3390/jcm11072018.
NIRO-Pulse is a novel mode of near-infrared spectroscopy that can be used to visually evaluate cerebral perfusion during cardiopulmonary resuscitation (CPR), providing real-time feedback as to the quality of the CPR. The aim of this report was to describe the several representative cases of NIRO-Pulse for physiological monitoring during CPR.
We present several cases from out-of-hospital cardiac arrest (OHCA) patients for whom NIRO-Pulse was attached to the forehead after hospital arrival. Patients were subjected to continuous brain monitoring during CPR using NIRO-Pulse, which allows for the visualisation of ΔHb (Hb pulsation). NIRO-Pulse is capable of simultaneously measuring and displaying cerebral tissue oxygen saturation (SctO2) and Hb pulsation, providing real-time feedback during CPR in the form of physiological indicators, and assessing changes in SctO2 throughout the CPR procedure by post-mortem analysis.
We observed several representative cases that provided the following insights: (1) SctO2 increased after a change in the quality of chest compression, (2) SctO2 decreased during the ventilation phase of synchronised CPR, (3) SctO2 decreased during the interruption of chest compressions for the preparation of defibrillation, and (4) SctO2 gradually and continuously increased after return of spontaneous circulation.
Displaying Hb pulsation in conjunction with SctO2 during CPR may be helpful for evaluating the quality of and patient responsiveness to CPR. Further studies investigating the association between the use of NIRO-Pulse during CPR and subsequent outcomes should be conducted.
NIRO-Pulse是一种新型近红外光谱模式，可用于在心肺复苏（CPR）期间直观评估脑灌注，为CPR质量提供实时反馈。本报告的目的是描述几例使用NIRO-Pulse进行CPR期间生理监测的典型病例。
我们展示了几例院外心脏骤停（OHCA）患者的病例，这些患者在入院后将NIRO-Pulse连接到前额。在CPR期间使用NIRO-Pulse对患者进行连续脑监测，该设备能够显示ΔHb（血红蛋白脉动）。NIRO-Pulse能够同时测量和显示脑组织氧饱和度（SctO2）和血红蛋白脉动，在CPR期间以生理指标的形式提供实时反馈，并通过事后分析评估整个CPR过程中SctO2的变化。
我们观察到几例典型病例，从中获得了以下见解：（1）胸外按压质量改变后SctO2升高；（2）同步CPR通气阶段SctO2降低；（3）为准备除颤而中断胸外按压期间SctO2降低；（4）自主循环恢复后SctO2逐渐持续升高。
在CPR期间结合显示血红蛋白脉动和SctO2可能有助于评估CPR质量和患者对CPR的反应性。应开展进一步研究，探讨CPR期间使用NIRO-Pulse与后续结果之间的关联。
