• Tsukasa Yagi, Ken Nagao, Kaoru Sakatani, Tsuyoshi Kawamorita, Taketomo Soga, Kimio Kikushima, Kazuhiro Watanabe, Eizo Tachibana, Yoshiteru Tominaga, Katsushige Tada, Ishii Mitsuru, Nobutaka Chiba, Kei Nishikawa, Masakazu Matsuzaki, Harumi Hirose, Atsuo Yoshino, and Atsushi Hirayama.
• Department of Cardiology, Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital, 1-8-13 Kanda Surugadai, Chiyoda-ku, Tokyo, 101-8309, Japan, ygt0108@livedoor.com.
• Adv Exp Med Biol. 2013 Jan 1;789:121-8.

BackgroundThe 2010 CPR Guidelines recommend that extracorporeal cardiopulmonary resuscitation (ECPR) using an emergency cardiopulmonary bypass (CPB) should be considered for patients with cardiac arrest. However, it is not yet clear whether this therapy can improve cerebral circulation and oxygenation in these patients. To clarify this issue, we evaluated changes of cerebral blood oxygenation (CBO) during ECPR using near-infrared spectroscopy (NIRS).MethodsWe employed NIRS to measure CBO in the bilateral frontal lobe in patients transported to the emergency room (ER) after out-of-hospital cardiac arrest between November 2009 and June 2011.ResultsFifteen patients met the above criteria. The tissue oxygenation index (TOI) on arrival at the ER was 36.5 %. This increased to 67.8 % during ECPR (P < 0.001). The one patient whose TOI subsequently decreased had a favorable neurological outcome.ConclusionIncrease of TOI during ECPR might reflect an improvement in cerebral blood flow, while decrease of TOI after ECPR might reflect oxygen utilization by the brain tissue as a result of neuronal cell survival. NIRS may be useful for monitoring cerebral hemodynamics and oxygen metabolism during CPR.

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