Noninvasive Cerebral Oximetry During CPR: Real-Time Predictor of ROSC

Kristi L. Koenig, MD, FACEP, FIFEM

Higher cerebral oximetry readings in patients with return of spontaneous circulation; no survival in those with persistent values <30%

A cerebral oximeter is a noninvasive monitor that is applied to a patient's forehead to measure regional cerebral oxygen saturation (rSO2). Normal rSO2 values are between 60% and 80%. In a 6-month observational pilot study, researchers examined results of continuous cerebral oximetry monitoring in a convenience sample of 50 adult patients in cardiac arrest.

Overall, 52% of patients achieved return of spontaneous circulation (ROSC). These patients had significantly higher mean rSO2 than patients who did not have ROSC (47% vs. 32%). No difference in mean rSO2 was observed between patients with and without ROSC among those with initial arrest rhythms of ventricular fibrillation or tachycardia (24%), but differences were significant among those with asystole (45% vs. 25%) and those with pulseless electrical activity (51% vs. 32%).

Citation(s):

Ahn A et al. A pilot study examining the role of regional cerebral oxygen saturation monitoring as a marker of return of spontaneous circulation in shockable (VF/VT) and non-shockable (PEA/asystole) causes of cardiac arrest. Resuscitation 2013 Aug 14; [e-pub ahead of print].