Wiest, Clemens and Philipp, Alois and Foltan, Maik and Lunz, Dirk and Merten, Christian and Blecha, Sebastian and Seyfried, Timo and Geismann, Florian and Schneckenpointner, Roland and Mueller, Thomas and Lubnow, Matthias (2021) Does cerebral near-infrared spectroscopy (NIRS) help to predict futile cannulation in extracorporeal cardiopulmonary resuscitation (ECPR)? RESUSCITATION, 168. pp. 186-190. ISSN 0300-9572, 1873-1570
Full text not available from this repository. (Request a copy)Abstract
Aim of the study: Extracorporeal cardiopulmonary resuscitation (ECPR) is an evolving technique to improve cardiopulmonary resuscitation (CPR) outcomes. Identifying a readily available tool helpful for predicting patient's outcome is warranted. The aim of the study was to evaluate the capability of cranial near-infrared spectroscopy (cNIRS) to identify non-survivors or patients with unfavorable neurologic outcome prior to cannulation for ECPR to avoid futile cannulations. Methods: Retrospective analysis (2015-2021) of 97 patients requiring ECPR due to cardiac arrest with prior cNIRS measurement, which was performed immediately after ECPR team arrived on scene. Lowest possible regional cerebral oxygen saturation (rSO(2)) is 15%. Results: Mortality was 72.1% (70/97). Survivors showed in 88.9% (24/27) good neurological outcome (Cerebral Performance Category (CPC) 1 + 2). rSO(2) = 15% (11/97) prior to cannulation was only found in non-survivors. Among survivors, initial rSO(2) was not associated with neurological outcome. Non-shockable initial rhythm was associated with higher mortality (44/50). In survivors, time to ECPR was shorter (p = 0.006), and initial lactate was significantly lower, whereas initial pH and hemoglobin levels were higher (p = 0.001). Survivors and those with favorable neurological outcome showed lower maximal NSE levels in the first 72 hours (p < 0.001; p = 0.041). Conclusion: In our patient cohort, rSO(2) = 15% immediately prior to cannulation for ECPR did not result in any survivors, thus might be a marker for futile cannulation in ECPR. Higher rSO(2) values were not associated with favorable neurologic outcome. Lower initial lactate and lower maximal NSE within the first 72 h after arrest were associated with favorable outcome.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HOSPITAL CARDIAC-ARREST; MULTICENTER; SURVIVAL; ECPR; NIRS; INVOS; Regional cerebral oxygen saturation; rSO(2); Resuscitation; Outcome; Cannulation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Aug 2022 05:46 |
| Last Modified: | 09 Aug 2022 05:46 |
| URI: | https://pred.uni-regensburg.de/id/eprint/46134 |
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