Shellen Samantha, Parnia Sam, Huppert Elise L, Gonzales Anelly M, Pollard Kenna
Critical Care and Resuscitation Research Program, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA.
Division of Pulmonary, Critical Care & Sleep Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA.
Resusc Plus. 2024 Apr 26;18:100644. doi: 10.1016/j.resplu.2024.100644. eCollection 2024 Jun.
Despite improvements in cardiopulmonary resuscitation (CPR), survival and neurologic recovery after cardiac arrest remain poor due to ischemia and subsequent reperfusion injury. As the likelihood of survival and favorable neurologic outcome decreases with increasing severity of ischemia during CPR, developing methods to measure the magnitude of ischemia during resuscitation is critical for improving overall outcomes. Cerebral oximetry, which measures regional cerebral oxygen saturation (rSO) by near-infrared spectroscopy, has emerged as a potentially beneficial marker of cerebral ischemia during CPR. In numerous preclinical and clinical studies, higher rSO during CPR has been associated with improved cardiac arrest survival and neurologic outcome. There is also emerging evidence that this can be integrated with electroencephalogram (EEG) monitoring to provide a bimodal system of brain monitoring during CPR. In this method's review, we discuss the feasibility, application, and implications of this integrated monitoring approach, highlighting its significance for improving clinical outcomes in cardiac arrest management and guiding future research directions.
尽管心肺复苏(CPR)技术有所改进,但由于缺血及随后的再灌注损伤,心脏骤停后的生存率和神经功能恢复情况仍然较差。随着心肺复苏期间缺血严重程度的增加,生存及获得良好神经功能转归的可能性降低,因此开发在复苏过程中测量缺血程度的方法对于改善总体预后至关重要。脑氧饱和度测定法通过近红外光谱测量局部脑氧饱和度(rSO),已成为心肺复苏期间脑缺血的一种潜在有益标志物。在众多临床前和临床研究中,心肺复苏期间较高的rSO与心脏骤停生存率提高及神经功能转归改善相关。也有新证据表明,这可以与脑电图(EEG)监测相结合,在心肺复苏期间提供一种双模式脑监测系统。在本方法综述中,我们讨论这种综合监测方法的可行性、应用及意义,强调其对改善心脏骤停管理临床预后及指导未来研究方向的重要性。