• Kei Nishiyama, Noritoshi Ito, Tomohiko Orita, Kei Hayashida, Hideki Arimoto, Mitsuru Abe, Takashi Unoki, Tomoyuki Endo, Akira Murai, Ken Ishikura, Noriaki Yamada, Masahiro Mizobuchi, Hideaki Anan, Tomorou Watanabe, Hideto Yasuda, Yosuke Homma, Kazuhiro Shiga, Michiaki Tokura, Yuka Tsujimura, Tetsuo Hatanaka, and Ken Nagao.
• Department of Primary Care and Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: keinishi@kuhp.kyoto-u.ac.jp.
• Resuscitation. 2015 Nov 1; 96: 16-22.

AimOur study aimed at filling the fundamental knowledge gap on the characteristics of regional brain oxygen saturation (rSO2) levels in out-of-hospital cardiac arrest (OHCA) patients with or without return of spontaneous circulation (ROSC) upon arrival at the hospital for estimating the quality of cardiopulmonary resuscitation and neurological prognostication in these patients.MethodsWe enrolled 1921 OHCA patients from the Japan - Prediction of Neurological Outcomes in Patients Post-cardiac Arrest Registry and measured their rSO2 immediately upon arrival at the hospital by near-infrared spectroscopy using two independent forehead probes (right and left). We also assessed the percentage of patients with a good neurological outcome (defined as cerebral performance categories 1 or 2) 90 days post cardiac arrest.ResultsAfter 90 days, 79 (4%) patients had good neurological outcomes and a median lower rSO2 level of 15% (15-20%). Compared to patients without ROSC upon arrival at the hospital, those with ROSC had significantly higher rSO2 levels (56% [39-65%] vs. 15% [15-17%], respectively; P<0.01), and significantly correlated right- and left-sided regional brain oxygen saturation levels (R=0.94 vs. 0.66, respectively). In both groups, the percentage of patients with a good 90-day neurological outcome increased significantly in proportion to their rSO2 levels upon arrival at the hospital (P<0.01).ConclusionOur data indicate that measuring rSO2 levels might be effective for both monitoring the quality of resuscitation and neurological prognostication in patients with OHCA.Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

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