• Dong Won Kim, ChoiJong KwanJKOBELAB Inc., Seoul, Republic of Korea., Seung Hyun Won, YunYong JuYJGraduate School of Energy and Environment (KU-KIST Green School), Korea University, Seoul, Republic of Korea., You Hwan Jo, Seung Min Park, Dong Keon Lee, and Dong-Hyun Jang.
• Department of Emergency Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea.
• Resuscitation. 2022 Jun 1; 175: 159-166.

Aim Of The StudyThis study aimed to investigate the effect of the head-up position implemented during cardiopulmonary resuscitation (CPR) on cerebral blood flow (CBF) using near-infrared spectroscopy in out-of-hospital cardiac arrest patients.MethodsBaseline characteristics (age, sex, cerebral performance category before cardiac arrest, witnessed cardiac arrest, bystander CPR, first monitored rhythm, no-flow time, prehospital low-flow time, CPR duration in the emergency department (ED), and reason for stopping CPR in the ED) were recorded. The changes of CBF were derived from the optical oscillation waveform measured by near-infrared spectroscopy in adult patients with out-of-hospital cardiac arrest by alternating head-up and supine positions at 4-minute intervals while performing CPR. The CBF velocity according to the head position was also evaluated using the time derivative of the oscillation waveform.ResultsDuring the study period, 28 patients were enrolled. The median increase in CBF in the prefrontal area in the head-up position was 14.6% (Interquartile range, 8.8-65.0), more than that in the supine position. An increase in CBF was observed in the head-up position compared with the supine position in 83.3% of the patients included in the analysis.ConclusionCBF increased when the head-up position was used during CPR in non-traumatic out-of-hospital cardiac arrest patients.Copyright © 2022 Elsevier B.V. All rights reserved.

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