Cerebral oximetry monitoring in OHCA
Burrell, Lisa Rice, Alan
Burrell, Lisa
Rice, Alan
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Abstract
Abstract published with permission.
Background: Cerebral oximetry allows non-invasive, real-time monitoring
information of cerebral blood flow. It has recently been used to provide
information about cerebral perfusion during resuscitation efforts in cases of
cardiac arrest and may give an indication of neurological survival. Most of
this information has been obtained during the hospital phase of treatment
and little is known about cerebral flow in the prehospital phase. Methods: A
systematic review was carried out, with the PubMed and EMBASE databases
searched to identify clinical trials where cerebral oximetry monitoring was
performed in the prehospital phase of out-of-hospital cardiac arrest. It aimed
specifically to answer the following questions: is cerebral oximetry monitoring
feasible in the prehospital environment? Can cerebral oximetry be used
as a useful marker of the quality of cardiopulmonary resuscitation in the
prehospital setting? Can cerebral oximetry be used to assist decisions around
prognostication and futility for out-of-hospital cardiac arrest? Results: Five
studies were identified for review. Feasibility was demonstrated in four of
these. The usefulness of cerebral oximetry in monitoring cardiopulmonary
resuscitation has not been well explored in out-of-hospital cardiac arrest.
Similarly, data linking intra-arrest cerebral oximetry values and prognosis
in out-of-hospital cardiac arrest is sparse. Conclusions: Cerebral oximetry
is feasible in out-of-hospital cardiac arrest but its usefulness in guiding
resuscitation attempts in this environment remains largely unknown.