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Original Research

Open Access

Initial five and ten-minute regional cerebral oxygen saturation as a predictor of the futility of resuscitation for out-of-hospital cardiac arrest

  • Jae Ho Jang1
  • Yong Su Lim1
  • Woo Sung Choi1
  • Jea Yeon Choi1
  • Jin Seong Cho1
  • Jae-Hyug Woo1
  • Hyuk Jun Yang1

1Department of Emergency Medicine, Gil Medical Center, Gachon University College of Medicine, 21556 Incheon, Republic of Korea

DOI: 10.22514/sv.2022.027

Submitted: 03 December 2021 Accepted: 10 February 2022

Online publish date: 01 April 2022

*Corresponding Author(s): Yong Su Lim E-mail: yongem@gilhospital.com

Abstract

This study aimed to investigate the usefulness of cerebral regional oxygen saturation (rSO2) during the initial 5 and 10 minutes of cardiopulmonary resuscitation (CPR) compared with an initial rSO2 and mean rSO2 during entire CPR to predict the futility of resuscitation for patients without of-hospital-cardiac arrest (OHCA). This was a prospective study involving 52 adult patients presenting in OHCA and whose cerebral rSO2 values were measured until either CPR was terminated or sustained return of spontaneous circulation (ROSC) was achieved. Receiver operating characteristics analyses were used to evaluate which time and type of measurement is better to predict non-ROSC. The area under the curve (AUC) of each rSO2 value according to measurement time (overall, initial 5 minutes and 10 minutes) were the highest value of 0.743, 0.724, and 0.739, mean values of 0.724, 0.677 and 0.701 and ∆rSO2 (Changes in values of regional cerebral oxygen) value of 0.722, 0.734 and 0.724, respectively, while all of the initial values had a poor AUC (<0.7) and also were not statistically significant. The optimal cut-off value of each rSO2 values during overall, initial 5 minutes and 10 minutes were the highest value of 26% (sensitivity, 53.9%; specificity, 92.3%), 24% (sensitivity, 56.4%; specificity, 92.3%), and 30% (sensitivity, 61.5%; specificity, 84.6%), mean value of 15.2%, 15.3% and 16%, respectively. None of the patients with a persistent rSO2 ≤18% during the overall period achieved ROSC. Initial 5 minutes and 10 minutes cerebral rSO2 values an out-of-hospital-cardiac arrest (OHCA) are a better predictor in deciding the futility of CPR, compared to initial and overall measurements.


Keywords

Out-of-hospital cardiac arrest; Cardiopulmonary resuscitation; Cerebral oximetry; Near-infrared spectroscopy; Futility of CPR


Cite and Share

Jae Ho Jang,Yong Su Lim,Woo Sung Choi,Jea Yeon Choi,Jin Seong Cho,Jae-Hyug Woo,Hyuk Jun Yang. Initial five and ten-minute regional cerebral oxygen saturation as a predictor of the futility of resuscitation for out-of-hospital cardiac arrest. Signa Vitae. 2022.doi:10.22514/sv.2022.027.

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