• Yasuaki Koyama, Yoshiaki Inoue, Shuhei Hisago, Aiki Marushima, Keiichi Hagiya, Yuichiro Yamasaki, Yuki Enomoto, Nobutake Shimojo, Satoru Kawano, and Taro Mizutani.
• Department of Emergency and Critical Care Medicine, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan. Electronic address: yasukoya@md.tsukuba.ac.jp.
• Am J Emerg Med. 2018 Feb 1; 36 (2): 344.e5-344.e7.

BackgroundThe neurological prognosis is poor for patients suffering from out-of-hospital cardiac arrest (OHCA), in the absence of bystander cardio pulmonary resuscitation (CPR), and showing asystole as the initial waveform. However, such patients have the potential of resuming social activity if cerebral tissue oxygen saturation can be preserved.Case PresentationWe recently encountered a 60-year-old man who had suffered an OHCA in the absence of bystander CPR, and who successfully resumed complete social activity despite initial asystole and requiring at least 75min of chest compressions before return of spontaneous circulation (ROSC). In this case, chest compression was appropriately performed concurrently with real-time evaluation of cerebral tissue oxygenation using near-infrared spectroscopy (NIRS). As a result, the cerebral tissue oxygenation was well maintained, leading to resumption of social activity.ConclusionsImproved neurological prognoses can be expected if OHCA patients with the potential for social activity resumption are identified, using NIRS, and effective cardiopulmonary and cerebral resuscitation is performed while visually checking CPR quality.Copyright © 2017 Elsevier Inc. All rights reserved.

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