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Detection of ROSC in Patients with Cardiac Arrest During Chest Compression Using NIRS: A Pilot Study

  • Tsukasa YagiEmail author
  • Ken Nagao
  • Tsuyoshi Kawamorita
  • Taketomo Soga
  • Mitsuru Ishii
  • Nobutaka Chiba
  • Kazuhiro Watanabe
  • Shigemasa Tani
  • Atsuo Yoshino
  • Atsushi Hirayama
  • Kaoru Sakatani
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 876)

Abstract

Return of spontaneous circulation (ROSC) during chest compression is generally detected by arterial pulse palpation and end-tidal CO2 monitoring; however, it is necessary to stop chest compression during pulse palpation, and to perform endotracheal intubation for monitoring end-tidal CO2. In the present study, we evaluated whether near-infrared spectroscopy (NIRS) allows the detection of ROSC during chest compression without interruption. We monitored cerebral blood oxygenation in 19 patients with cardiac arrest using NIRS (NIRO-200NX, Hamamatsu Photonics, Japan). On arrival at the emergency room, the attending physicians immediately assessed whether a patient was eligible for this study after conventional advanced life support (ALS) and employed NIRS to measure cerebral blood oxygenation (CBO) in the bilateral frontal lobe in patients. We found cerebral blood flow waveforms in synchrony with chest compressions in all patients. In addition, we observed abrupt increases of oxy-hemoglobin concentration and tissue oxygen index (TOI), which were associated with ROSC detected by pulse palpation. The present findings indicate that NIRS can be used to assess the quality of chest compression in patients with cardiac arrest as demonstrated by the detection of synchronous waveforms during cardiopulmonary resuscitation (CPR). NIRS appears to be applicable for detection of ROSC without interruption of chest compression and without endotracheal intubation.

Keywords

Cardiac arrest Cardiopulmonary resuscitation Near-infrared spectroscopy Quality of cardiopulmonary resuscitation Return of spontaneous circulation 

References

  1. 1.
    International Liaison Committee on Resuscitation (2010) 2010 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation 122:S250–S605CrossRefGoogle Scholar
  2. 2.
    American Heart Association (2010) 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 122:S639–S946CrossRefGoogle Scholar
  3. 3.
    Kitamura T, Iwami T, Kawamura T, Implementation Working Group for All-Japan Utstein Registry of the Fire and Disaster Management Agency et al (2010) Nationwide public access defibrillation in Japan. N Engl J Med 362:994–1004CrossRefPubMedGoogle Scholar
  4. 4.
    Iwami T, Kitamura T, Kawamura T et al (2012) Chest compression-only cardiopulmonary resuscitation for out-of-hospital cardiac arrest with public-access defibrillation: a nationwide cohort study. Circulation 126:2844–2851CrossRefPubMedGoogle Scholar
  5. 5.
    Japanese Circulation Society Resuscitation Science Study Group (2013) Chest-compression-only bystander cardiopulmonary resuscitation in the 30:2 compression-to-ventilation ratio era. Nationwide observational study. Circ J 77:2742–2750CrossRefGoogle Scholar
  6. 6.
    Samra SK, Dorjie P, Zelenock GB et al (1996) Cerebral oximetry in patients undergoing carotid endarterectomy. Stroke 27:49–55CrossRefPubMedGoogle Scholar
  7. 7.
    Nakamura S, Kano T, Sakatani K et al (2009) Optical topography can predict occurrence of watershed infarction during carotid endarterectomy: technical case report. Surg Neurol 71:540–542CrossRefPubMedGoogle Scholar
  8. 8.
    Cummins RO, Chamberlain DA, Abramson NS et al (1991) Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein Style – a statement for health professionals from a task force of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, and the Australian Resuscitation Council. Circulation 84:960–975CrossRefPubMedGoogle Scholar
  9. 9.
    Nagao K, Hayashi N, Kanmatsuse K et al (2000) Cardiopulmonary cerebral resuscitation using emergency cardiopulmonary bypass, coronary reperfusion therapy and mild hypothermia in patients with cardiac arrest outside the hospital. J Am Coll Cardiol 36:776–783CrossRefPubMedGoogle Scholar
  10. 10.
    Nagao K, Kikushima K, Watanabe K et al (2010) Early induction of hypothermia during cardiac arrest improves neurological outcomes in patients with out-of-hospital cardiac arrest who undergo emergency cardiopulmonary bypass and percutaneous coronary intervention. Circ J 74:77–85CrossRefPubMedGoogle Scholar
  11. 11.
    Yagi T, Nagao K, Sakatani K et al (2013) Changes of cerebral oxygen metabolism and hemodynamics during ECPR with hypothermia measured by near-infrared spectroscopy: a pilot study. Adv Exp Med Biol 789:121–128CrossRefPubMedGoogle Scholar
  12. 12.
    Koyama Y, Wada T, Lohman BD et al (2013) A new method to detect cerebral blood flow waveform in synchrony with chest compression by near-infrared spectroscopy during CPR. Am J Emerg Med 31:1504–1508CrossRefPubMedGoogle Scholar
  13. 13.
    Ito N, Nishiyama K, Callaway CW et al (2014) Noninvasive regional cerebral oxygen saturation for neurological prognostication of patients with out-of-hospital cardiac arrest: a prospective multicenter observational study. Resuscitation 85:778–784CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, New York 2016

Authors and Affiliations

  • Tsukasa Yagi
    • 1
    • 2
    Email author
  • Ken Nagao
    • 1
  • Tsuyoshi Kawamorita
    • 2
  • Taketomo Soga
    • 1
    • 2
  • Mitsuru Ishii
    • 2
  • Nobutaka Chiba
    • 2
  • Kazuhiro Watanabe
    • 1
    • 2
  • Shigemasa Tani
    • 1
  • Atsuo Yoshino
    • 3
  • Atsushi Hirayama
    • 4
  • Kaoru Sakatani
    • 3
    • 5
  1. 1.Department of CardiologyNihon University HospitalChiyoda-ku, TokyoJapan
  2. 2.Department of Emergency and Critical Care MedicineNihon University HospitalTokyoJapan
  3. 3.Division of Neurosurgery, Department of Neurological SurgeryNihon University School of MedicineTokyoJapan
  4. 4.Division of Cardiology, Department of MedicineNihon University School of MedicineTokyoJapan
  5. 5.NEWCAT Institute, Nihon University College of EngineeringKoriyamaJapan

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