• Cornelia Genbrugge, Ingrid Meex, Willem Boer, Frank Jans, René Heylen, Bert Ferdinande, Jo Dens, and Cathy De Deyne.
• Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium. cornelia.genbrugge@uhasselt.be.
• Crit Care. 2015 Jan 1;19:112.

IntroductionBy maintaining sufficient cerebral blood flow and oxygenation, the goal of cardiopulmonary resuscitation (CPR) is to preserve the pre-arrest neurological state. To date, cerebral monitoring abilities during CPR have been limited. Therefore, we investigated the time-course of cerebral oxygen saturation values (rSO₂) during advanced life support in out-of-hospital cardiac arrest. Our primary aim was to compare rSO₂ values during advanced life support from patients with return of spontaneous circulation (ROSC) to patients who did not achieve ROSC.MethodsWe performed an observational study to measure rSO₂ using Equanox (Nonin, Plymouth, MI) from the start of advanced life support in the pre-hospital setting.ResultsrSO₂ of 49 consecutive out-of-hospital cardiac arrest patients were analyzed. The total increase from initial rSO₂ value until two minutes before ROSC or end of advanced life support efforts was significantly larger in the group with ROSC 16% (9 to 36) compared to the patients without ROSC 10% (4 to 15) (P = 0.02). Mean rSO₂ from the start of measurement until two minutes before ROSC or until termination of advanced life support was higher in patients with ROSC than in those without, namely 39% ± 7 and 31% ± 4 (P = 0.05) respectively.ConclusionsDuring pre-hospital advanced life support, higher increases in rSO₂ are observed in patients attaining ROSC, even before ROSC was clinically determined. Our findings suggest that rSO₂ could be used in the future to guide patient tailored treatment during cardiac arrest and could therefore be a surrogate marker of the systemic oxygenation state of the patient.

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