Higher mean cerebral oxygen saturation shortly after extracorporeal cardiopulmonary resuscitation in patients who regain consciousness

• Published in: Artificial organs Vol. 47; no. 9; pp. 1479 - 1489
• Main Authors: Mandigers, Loes, den Uil, Corstiaan A, Belliato, Mirko, Raemen, Hannelore, Rossi, Eleonora, van Rosmalen, Joost, Rietdijk, Wim J R, Melis, Joo-Ree, Gommers, Diederik, van Thiel, Robert J, Dos Reis Miranda, Dinis
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.09.2023
• Subjects: Cardiac arrest; Cardiopulmonary resuscitation; Cerebral blood flow; Consciousness; CPR; Ischemia; Observational studies; Oxygen; Oxygen content; Oxygen saturation; Oxygenation; Reperfusion; Resuscitation; Statistical analysis; ECPR; near-infrared spectroscopy; cerebral regional oxygen saturation; extracorporeal cardiopulmonary resuscitation; extracorporeal membrane oxygenation; heart arrest; cardiac arrest
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1111/aor.14548

In cardiac arrest, cerebral ischemia and reperfusion injury mainly determine the neurological outcome. The aim of this study was to investigate the relation between the course of cerebral oxygenation and regain of consciousness in patients treated with extracorporeal cardiopulmonary resuscitation (ECPR). We hypothesized that rapid cerebral oxygenation increase causes unfavorable outcomes. This prospective observational study was conducted in three European hospitals. We included adult ECPR patients between October 2018 and March 2020, in whom cerebral regional oxygen saturation (rSO ) measurements were started minutes before ECPR initiation until 3 h after. The primary outcome was regain of consciousness, defined as following commands, analyzed using binary logistic regression. The sample consisted of 26 ECPR patients (23% women, Age 46 years). We found no significant differences in rSO values at baseline (49.1% versus 49.3% for regain versus no regain of consciousness). Mean cerebral rSO values in the first 30 min after ECPR initiation were higher in patients who regained consciousness (38%) than in patients who did not regain consciousness (62%, odds ratio 1.23, 95% confidence interval 1.01-1.50). Higher mean cerebral rSO values in the first 30 min after initiation of ECPR were found in patients who regained consciousness.