Near-infrared spectroscopy after out-of-hospital cardiac arrest

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http://hdl.handle.net/10138/302368

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Jakkula , P , Hästbacka , J , Reinikainen , M , Pettilä , V , Loisa , P , Tiainen , M , Wilkman , E , Bendel , S , Birkelund , T , Pulkkinen , A , Bäcklund , M , Heino , S , Karlsson , S , Kopponen , H & Skrifvars , M B 2019 , ' Near-infrared spectroscopy after out-of-hospital cardiac arrest ' , Critical Care , vol. 23 , 171 . https://doi.org/10.1186/s13054-019-2428-3

Title: Near-infrared spectroscopy after out-of-hospital cardiac arrest
Author: Jakkula, Pekka; Hästbacka, Johanna; Reinikainen, Matti; Pettilä, Ville; Loisa, Pekka; Tiainen, Marjaana; Wilkman, Erika; Bendel, Stepani; Birkelund, Thomas; Pulkkinen, Anni; Bäcklund, Minna; Heino, Sirkku; Karlsson, Sari; Kopponen, Hiski; Skrifvars, Markus B.
Contributor: University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, HYKS erva
University of Helsinki, Neurologian yksikkö
University of Helsinki, Clinicum
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki, Department of Diagnostics and Therapeutics
Date: 2019-05-14
Language: eng
Number of pages: 8
Belongs to series: Critical Care
ISSN: 1466-609X
URI: http://hdl.handle.net/10138/302368
Abstract: BackgroundCerebral hypoperfusion may aggravate neurological damage after cardiac arrest. Near-infrared spectroscopy (NIRS) provides information on cerebral oxygenation but its relevance during post-resuscitation care is undefined. We investigated whether cerebral oxygen saturation (rSO(2)) measured with NIRS correlates with the serum concentration of neuron-specific enolase (NSE), a marker of neurological injury, and with clinical outcome in out-of-hospital cardiac arrest (OHCA) patients.MethodsWe performed a post hoc analysis of a randomised clinical trial (COMACARE, NCT02698917) comparing two different levels of carbon dioxide, oxygen and arterial pressure after resuscitation from OHCA with ventricular fibrillation as the initial rhythm. We measured rSO(2) in 118 OHCA patients with NIRS during the first 36h of intensive care. We determined the NSE concentrations from serum samples at 48h after cardiac arrest and assessed neurological outcome with the Cerebral Performance Category (CPC) scale at 6months. We evaluated the association between rSO(2) and serum NSE concentrations and the association between rSO(2) and good (CPC 1-2) and poor (CPC 3-5) neurological outcome.ResultsThe median (inter-quartile range (IQR)) NSE concentration at 48h was 17.5 (13.4-25.0) g/l in patients with good neurological outcome and 35.2 (22.6-95.8) g/l in those with poor outcome, p
Subject: Cardiac arrest
Cerebral oxygenation
Hypoxic ischemic encephalopathy
Intensive care
Neuron-specific enolase (NSE)
CEREBRAL OXYGEN-SATURATION
OXIMETRY
RESUSCITATION
3126 Surgery, anesthesiology, intensive care, radiology
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