Putowski Mateusz, Dudzikowska Magdalena, Siudak Zbigniew
Jan Kochanowski University, Collegium Medicum, Kielce, Poland; Jagiellonian University Medical College, Center for Innovative Medical Education, Kraków, Poland; Department of Anesthesiology and Intensive Care, University Hospital in Krakow, Kraków, Poland.
Jan Kochanowski University, Collegium Medicum, Kielce, Poland
Pol Arch Intern Med. 2025 Mar 24;135(3). doi: 10.20452/pamw.16914. Epub 2025 Jan 2.
Cerebral oximetry measurement using near‑infrared spectroscopy (NIRS) has been highlighted as a technology that can provide noninvasive information on regional cerebral oxygen saturation (rSO2) during cardiopulmonary resuscitation (CPR), even though its effectiveness has not been fully confirmed. The research focused on the use of NIRS to predict the return of spontaneous circulation (ROSC) and neurological outcomes.
The purpose of the study was to evaluate the validity of rSO2 vs end‑tidal carbon dioxide (ETCO2) measurement during CPR and its association with ROSC, as well as to assess the neuroprognostic value of NIRS.
The study was carried out from January 11, 2023 to January 31, 2024, at the University Hospital, Kraków, Poland. The study group included 104 patients who experienced in‑hospital cardiac arrest. The values of rSO2 and ETCO2 were monitored during CPR and for 24 hours after ROSC.
The group of patients who achieved spontaneous circulation during CPR (ROSC group) had higher rSO2 values than the non‑ROSC group throughout the resuscitation period (63.8% vs 35.6%; P <0.001). Cerebral oximetry demonstrated higher predictive efficacy of rSO2 than ETCO2 as an indicator of ROSC (area under the curve [AUC], 0.978 vs 0.815; P <0.001). The mean rSO2 value equal to or above 66% during CPR was associated with a higher chance of survival within 30 days (AUC, 0.992; 95% CI, 0.98-1).
The rSO2 value is a more sensitive indicator of ROSC than ETCO2. Higher rSO2 values are associated with a higher probability of achieving ROSC. The monitoring of rSO2 during CPR provides prognostic information.
使用近红外光谱（NIRS）进行脑氧饱和度测量作为一种能够在心肺复苏（CPR）期间提供关于局部脑氧饱和度（rSO2）的非侵入性信息的技术已受到关注，尽管其有效性尚未得到充分证实。该研究聚焦于使用NIRS预测自主循环恢复（ROSC）和神经学结局。
本研究的目的是评估CPR期间rSO2与呼气末二氧化碳（ETCO2）测量的有效性及其与ROSC的关联，以及评估NIRS的神经预后价值。
该研究于2023年1月11日至2024年1月31日在波兰克拉科夫大学医院进行。研究组包括104例发生院内心脏骤停的患者。在CPR期间以及ROSC后24小时监测rSO2和ETCO2值。
在CPR期间实现自主循环的患者组（ROSC组）在整个复苏期间的rSO2值高于未实现自主循环的组（63.8%对35.6%；P<0.001）。脑氧饱和度测量显示，作为ROSC的指标，rSO2比ETCO2具有更高的预测效能（曲线下面积[AUC]，0.978对0.815；P<0.001）。CPR期间平均rSO2值等于或高于66%与30天内更高的存活几率相关（AUC，0.992；95%CI，0.98 - 1）。
rSO2值是比ETCO2更敏感的ROSC指标。更高的rSO2值与实现ROSC的更高概率相关。CPR期间对rSO2的监测可提供预后信息。
