Dataset Information

Skeletal muscle oxygenation during cardiopulmonary resuscitation as a predictor of return of spontaneous circulation: a pilot study.

ABSTRACT:

Background

Near-infrared spectroscopy (NIRS) provides regional tissue oxygenation (rSO₂) even in pulseless states, such as out-of-hospital cardiac arrest (OHCA). Brain rSO₂ seems to be important predictor of return of spontaneous circulation (ROSC) during cardiopulmonary resuscitation (CPR). Aim of our study was to explore feasibility for monitoring and detecting changes of skeletal muscle rSO₂ during resuscitation.

Methods

Skeletal muscle and brain rSO₂ were measured by NIRS (SenSmart Model X-100, Nonin, USA) during CPR in adult patient with OHCA. Start (basal) rSO₂, maximal during CPR (maximal) and difference between maximal-minimal rSO₂ (delta-rSO₂), were recorded. Patients were divided into ROSC and NO-ROSC group.

Results

20 patients [age: 66.0ys (60.5-79.5), 65% male] with OHCA [50% witnessed, 70% BLS, time to ALS 13.5 min (11.0-19.0)] were finally analyzed. ROSC was confirmed in 5 (25%) patients. Basal and maximal skeletal muscle rSO₂ were higher in ROSC compared to NO-ROSC group [49.0% (39.7-53.7) vs. 15.0% (12.0-25.2), P = 0.006; 76.0% (52.7-80.5) vs. 34.0% (18.0-49.5), P = 0.005, respectively]. There was non-linear cubic relationship between time of collapse and basal skeletal muscle rSO₂ in witnessed OHCA and without BLS (F-ratio = 9.7713, P = 0.0261). There was correlation between maximal skeletal muscle and brain rSO₂ (n = 18, rho: 0.578, P = 0.0121).

Conclusions

Recording of skeletal muscle rSO₂ during CPR in patients with OHCA is feasible. Basal and maximal skeletal muscle rSO₂ were higher in ROSC compared to NO-ROSC group. Clinical trial registration number ClinicalTrials.gov, NCT04058925, registered on: 16th August 2019. URL of trial registry record: https://www.

Clinicaltrials

gov/ct2/show/NCT04058925?titles=Tissue+Oxygenation+During+Cardiopulmonary+Resuscitation+as+a+Predictor+of+Return+of+Spontaneous+Circulation&draw=2&rank=1 .

SUBMITTER: Kosir M

PROVIDER: S-EPMC10566100 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

Skeletal muscle oxygenation during cardiopulmonary resuscitation as a predictor of return of spontaneous circulation: a pilot study.

Košir Miha M Možina Hugon H Podbregar Matej M

European journal of medical research 20231011 1

<h4>Background</h4>Near-infrared spectroscopy (NIRS) provides regional tissue oxygenation (rSO<sub>2</sub>) even in pulseless states, such as out-of-hospital cardiac arrest (OHCA). Brain rSO<sub>2</sub> seems to be important predictor of return of spontaneous circulation (ROSC) during cardiopulmonary resuscitation (CPR). Aim of our study was to explore feasibility for monitoring and detecting changes of skeletal muscle rSO<sub>2</sub> during resuscitation.<h4>Methods</h4>Skeletal muscle and brai ...[more]

PMID: 37821950

Similar Datasets

Project description:BackgroundThis study aimed to construct and internally validate a probability of the return of spontaneous circulation (ROSC) rate nomogram in a Chinese population of patients with cardiac arrest (CA).MethodsPatients with CA receiving standard cardiopulmonary resuscitation (CPR) were studied retrospectively. The minor absolute shrinkage and selection operator (LASSO) regression analysis and multivariable logistic regression evaluated various demographic and clinicopathological characteristics. A predictive nomogram was constructed and evaluated for accuracy and reliability using C-index, the area under the receiver operating characteristic curve (AUC), calibration plot, and decision curve analysis (DCA).ResultsA cohort of 508 patients who had experienced CA and received standard CPR was randomly divided into training (70 %, n = 356) and validation groups (30 %, n = 152) for the study. LASSO regression analysis and multivariable logistic regression revealed that thirteen variables, such as age, CPR start time, Electric defibrillation, Epinephrine, Sodium bicarbonate (NaHCO3), CPR Compression duration, The postoperative prothrombin (PT) time, Lactate (Lac), Cardiac troponin (cTn), Potassium (K+), D-dimer, Hypertension (HBP), and Diabetes mellitus (DM), were found to be independent predictors of the ROSC rate of CPR. The nomogram model showed exceptional discrimination, with a C-index of 0.933 (95 % confidence interval: 0.882-0.984). Even in the internal validation, a remarkable C-index value of 0.926 (95 % confidence interval: 0.875-0.977) was still obtained. The accuracy and reliability of the model were also verified by the AUC of 0.923 in the training group and 0.926 in the validation group. The calibration curve showed the model agreed with the actual results. DCA suggested that the predictive nomogram had clinical utility.ConclusionsA predictive nomogram model was successfully established and proved to identify the influencing factors of the ROSC rate in patients with CA. During cardiopulmonary resuscitation, adjusting the emergency treatment based on the influence factors on ROSC rate is suggested to improve the treatment rate of patients with CA.

Dataset Information

Skeletal muscle oxygenation during cardiopulmonary resuscitation as a predictor of return of spontaneous circulation: a pilot study.

Background

Methods

Results

Conclusions

Clinicaltrials

Publications

Skeletal muscle oxygenation during cardiopulmonary resuscitation as a predictor of return of spontaneous circulation: a pilot study.

Similar Datasets

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