Monitoring tissue oxygenation index using near-infrared spectroscopy during pre-hospital resuscitation among out-of-hospital cardiac arrest patients: a pilot study

Authors

Jumpei Tsukuda, Thomas Jefferson UniversityFollow
Shigeki Fujitani, St. Marianna University School of Medicine
Mahbubur Rahman, St. Luke's International University
Kenichiro Morisawa, St. Marianna University School of Medicine
Takeshi Kawaguchi, St. Marianna University School of Medicine
Yasuhiko Taira, St. Marianna University School of Medicine

Document Type

Article

Publication Date

3-4-2021

Comments

This article is the author’s final published version in Scandinavian journal of trauma, resuscitation and emergency medicine, Volume 29, Issue 1, March 2021, Page 42.

The published version is available at https://doi.org/10.1186/s13049-021-00857-7. Copyright © Tsukuda et al.

Abstract

BACKGROUND: Tissue oxygenation index (TOI) using the near infrared spectroscopy (NIRS) has been demonstrated as a useful indicator to predict return of spontaneous circulation (ROSC) among out-of-hospital cardiac arrest (OHCA) patients in hospital setting. However, it has not been widely examined based on pre-hospital setting.

METHODS: In this prospective observational study, we measured TOI in pre-hospital setting among OHCA patients receiving cardio-pulmonary resuscitation (CPR) during ambulance transportation between 2017 and 2018. Throughout the pre-hospital CPR procedure, TOI was continuously measured. The study population was divided into two subgroups: ROSC group and non-ROSC group.

RESULTS: Of the 81 patients included in the final analysis, 26 achieved ROSC and 55 did not achieve ROSC. Patients in the ROSC group were significantly younger, had higher ∆TOI (changes in TOI) (5.8 % vs. 1.3 %; p < 0.01), and were more likely to have shockable rhythms and event witnessed than patients in the non-ROSC group. ∆TOI cut-off value of 5 % had highest sensitivity (65.4 %) and specificity (89.3 %) for ROSC. Patients with a cut-off value ≤-2.0 % did not achieve ROSC and while all OHCA patient with a cut-off value ≥ 8.0 % achieved ROSC. In addition, ROSC group had stronger positive correlation between mean chest compression rate and ∆TOI (r = 0.82) than non-ROSC group (r = 0.50).

CONCLUSIONS: This study suggests that ∆ TOI could be a useful indicator to predict ROSC in a pre-hospital setting.

Recommended Citation

Tsukuda, Jumpei; Fujitani, Shigeki; Rahman, Mahbubur; Morisawa, Kenichiro; Kawaguchi, Takeshi; and Taira, Yasuhiko, "Monitoring tissue oxygenation index using near-infrared spectroscopy during pre-hospital resuscitation among out-of-hospital cardiac arrest patients: a pilot study" (2021). Department of Emergency Medicine Faculty Papers. Paper 132.
https://jdc.jefferson.edu/emfp/132

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

33663569

Language

English