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Observational Study
A new method to detect cerebral blood flow waveform in synchrony with chest compression by near-infrared spectroscopy during CPR.
- Yasuhiko Taira, Shigeki Fujitani, Brandon D Lohman, Yuka Takamatsu, and Junichi Matsumoto.
- Departments of Emergency and Critical Care Medicine, St Marianna University School of Medicine, Miyamae-ku, Kawasaki-shi, Kanagawa 216-8511, Japan. Electronic address: yasukoya@marianna-u.ac.jp.
- Am J Emerg Med. 2013 Oct 1;31(10):1504-8.
ObjectiveThe objective of the study is to demonstrate the utility of near-infrared spectroscopy (NIRS) in evaluating chest compression (CC) quality in cardiac arrest (CA) patients as well as determine its prognosis predictive value.MethodsWe present a nonconsecutive case series of adult patients with CA whose cardiopulmonary resuscitation (CPR) was monitored with NIRS and collected the total hemoglobin concentration change (ΔcHb), the tissue oxygen index (TOI), and the ΔTOI to assess CC quality in a noninvasive fashion.ResultsDuring CPR, ΔcHb displayed waveforms monitor, which we regarded as a surrogate for CC quality. Total hemoglobin concentration change waveforms responded accurately to variations or cessations of CCs. In addition, a TOI greater than 40% measured upon admission appears to be significant in predicting patient's outcome. Of 15 patients, 6 had a TOI greater than 40% measured upon admission, and 67% of the latter were in return of spontaneous circulation after CPR and were found to be significantly different between return of spontaneous circulation and death (P = .047; P < .05).ConclusionNear-infrared spectroscopy reliably assesses the quality of CCs in patients with CA demonstrated by synchronous waveforms during CPR and possible prognostic predictive value, although further investigation is warranted.© 2013 Elsevier Inc. All rights reserved.
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