Cerebral oxygen desaturation events during and functional outcomes after prehospital anaesthesia : A prospective pilot study

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Nurmi , J , Laukkanen-Nevala , P , Kirves , H , Raatiniemi , L , Toivonen , T , Tommila , M , Piiroinen , H , Setälä , P , Karhivuori , P , Tukia , S & Olkinuora , A 2022 , ' Cerebral oxygen desaturation events during and functional outcomes after prehospital anaesthesia : A prospective pilot study ' , Acta Anaesthesiologica Scandinavica , vol. 66 , no. 6 , pp. 750-758 . https://doi.org/10.1111/aas.14066

Title: Cerebral oxygen desaturation events during and functional outcomes after prehospital anaesthesia : A prospective pilot study
Author: Nurmi, Jouni; Laukkanen-Nevala, Päivi; Kirves, Hetti; Raatiniemi, Lasse; Toivonen, Tuukka; Tommila, Miretta; Piiroinen, Heini; Setälä, Piritta; Karhivuori, Pamela; Tukia, Simo; Olkinuora, Anna
Contributor organization: HUS Emergency Medicine and Services
Clinicum
University of Helsinki
Hyvinkää Hospital Area
Date: 2022-07
Language: eng
Number of pages: 9
Belongs to series: Acta Anaesthesiologica Scandinavica
ISSN: 0001-5172
DOI: https://doi.org/10.1111/aas.14066
URI: http://hdl.handle.net/10138/346074
Abstract: Background: During prehospital anaesthesia, oxygen delivery to the brain might be inadequate to match the oxygen consumption, with unknown long-term functional outcomes. We aimed to evaluate the feasibility of monitoring cerebral oxygenation during prehospital anaesthesia and determining the long-term outcomes. Methods: We performed a prospective observational feasibility study in two helicopter emergency medical services units. Frontal lobe regional oxygen saturation (rSO(2)) of adult patients undergoing prehospital anaesthesia was monitored with near-infrared spectroscopy (NIRS) by a Nonin H500 oximeter. The outcome was evaluated with a modified Rankin Scale (mRS) at 30 days and 1 year. Health-related quality of life (HRQoL) was measured with a 15D instrument at 1 year. Results: Of 101 patients enrolled, 83 were included. The mean baseline rSO(2) was 79% (73-84). Desaturation for at least 5 min to rSO(2) below 50% or a decrease of 10% from baseline occurred in four (5%, 95% CI 2%-12%) and 19 (23%, 95% CI 15-93) patients. At 1 year, 32 patients (53%, 95% CI 41-65) achieved favourable neurological outcomes. The median 15D score was 0.889 (Q1-Q3, 0.796-0.970). Conclusion: Monitoring cerebral oxygenation with a hand-held oximeter during prehospital anaesthesia and collecting data on functional outcomes and HRQoL are feasible. Only half of the patients achieved a favourable functional outcome. The effects of cerebral oxygenation on outcomes during prehospital critical care need to be assessed in future studies.
Subject: cerebral oxygenation
helicopter emergency
medical services
near-infrared spectroscopy
prehospital anaesthesia
QUALITY-OF-LIFE
TRAUMATIC BRAIN-INJURY
15D INSTRUMENT
BLOOD-FLOW
PRESSURE
AUTOREGULATION
CARE
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


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