Higher mean cerebral oxygen saturation shortly after extracorporeal cardiopulmonary resuscitation in patients who regain consciousness
Abstract
Introduction
In cardiac arrest, cerebral ischaemia 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 unfavourable outcomes.
Methods
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 (rSO2) measurements were started minutes before ECPR initiation until three hours after. The primary outcome was regain of consciousness, defined as following commands, analyzed using binary logistic regression.
Results
The sample consisted of 26 ECPR patients (23% women, Agemean 46 years).We found no significant differences in rSO2 values at baseline (49.1% versus 49.3% for regain versus no regain of consciousness). Mean cerebral rSO2 values in the first 30 minutes 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).
Conclusion
Higher mean cerebral rSO2 values in the first 30 minutes after initiation of ECPR were found in patients who regained consciousness.