Noritoshi Ito1, Kei Nishiyama2, Clifton W Callaway3, Tomohiko Orita4, Kei Hayashida5, Hideki Arimoto6, Mitsuru Abe7, Tomoyuki Endo8, Akira Murai9, Ken Ishikura10, Noriaki Yamada11, Masahiro Mizobuchi12, Hideki Anan13, Kazuo Okuchi14, Hideto Yasuda15, Toshiaki Mochizuki16, Yuka Tsujimura17, Takeo Nakayama17, Tetsuo Hatanaka18, Ken Nagao19. 1. Senri Cardiovascular Center, Osaka Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka 565-0862, Japan; Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. 2. Department of Primary Care and Emergency Medicine, Kyoto University Graduate School of Medicine, 54 Kawara-machi, Seigoin, Sakyo-ku, Kyoto 606-8507, Japan. Electronic address: keinishi@kuhp.kyoto-u.ac.jp. 3. Department of Emergency Medicine, University of Pittsburgh, Iroquois Building, Suite 400A, 3600 Forbes Avenue, Pittsburgh, PA 15261, United States. 4. Department of Emergency and Critical Care Medicine, Saiseikai Yokohamashi Tobu Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa 230-0012, Japan. 5. Emergency and Critical Care Medicine, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan. 6. Department of Emergency and Critical Care Medical Center, Osaka City General Hospital, 2-13-22 Miyakojima Hon-Dori, Miyakojima-ku, Osaka 534-0021, Japan. 7. Department of Cardiology, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusamukaihatachou, Fushimi-ku, Kyoto 612-8555, Japan. 8. Advanced Emergency Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan. 9. Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jyonan-ku, Fukuoka 814-0180, Japan. 10. Critical Care Center, Mie University Hospital, 174 Edobashi 2-chome, Tsu, Mie 514-8507, Japan. 11. Advanced Critical Care Center, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan. 12. Department of Cardiology, Kyoto Katsura Hospital, 17-Banchi, Yamada Hirao-cho, Nishikyo-ku, Kyoto 615-8256, Japan. 13. Division of Emergency Medicine, Fujisawa City Hospital, 2-6-1 Fujisawa, Kanagawa 251-8550, Japan. 14. Advanced Critical Care Center, Nara Medical University Hospital, 840 Shijocho, Kashihara, Nara 634-8522, Japan. 15. Emergency and Critical Care Medicine, Japanese Red Cross Musashino Hospital, 1-26-1 Sakai Minami Town, Musashino, Tokyo 180-8610, Japan. 16. Department of Emergency and Critical Care Medicine St Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan. 17. Department of Health Informatics, Kyoto University School of Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan. 18. Emergency Life Saving Technique Academy, 3-8-1 Oura, Yahata-nishi-ku, Kitakyushu, Fukuoka 807-0874, Japan. 19. Department of Cardiology, Surugadai Nihon University Hospital, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan.
Abstract
AIM: To investigate the association between regional brain oxygen saturation (rSO2) at hospital arrival and neurological outcomes at 90 days in patients with out-of-hospital cardiac arrest (OHCA). METHODS: The Japan-Prediction of neurological Outcomes in patients post cardiac arrest (J-POP) registry is a prospective, multicenter, cohort study to test whether rSO2 predicts neurological outcomes after OHCA. We measured rSO2 in OHCA patients immediately after hospital arrival using a near-infrared spectrometer placed on the forehead with non-blinded fashion. The primary endpoint was "neurological outcomes" at 90 days after OHCA. RESULTS: EMS providers are not permitted to terminate CPR in the field in Japan, and so most patients with OHCA who are treated by EMS personnel are transported to emergency hospitals. Among 1017 OHCA patients, 672 patients including 52 comatose patients with pulses detectable (8%) and 620 cardiac arrest patients (92%) at hospital arrival were enrolled prospectively and consecutively. Twenty-nine patients with good neurological outcome had a significantly higher value of rSO2 at hospital arrival than 643 patients with poor neurological outcome (mean [±SD] 55.6±20.8% vs. 19.7±11.0%, p<0.001). Receiver operating curve analysis indicated an optimal rSO2 cutoff point of >42% for predicting good neurological outcome, with sensitivity 0.79 (95% confidence interval [CI], 0.60-0.92), specificity 0.95 (95% CI, 0.93-0.96), positive predictive value, 0.41 (95% CI, 0.28-0.55), negative predictive value, 0.99 (95% CI, 0.98-1.00), and area under the curve 0.90 (95% CI, 0.88-0.92). CONCLUSION: The rSO2 at hospital arrival can predict good neurological outcome at 90 days after OHCA.
AIM: To investigate the association between regional brain oxygen saturation (rSO2) at hospital arrival and neurological outcomes at 90 days in patients with out-of-hospital cardiac arrest (OHCA). METHODS: The Japan-Prediction of neurological Outcomes in patients post cardiac arrest (J-POP) registry is a prospective, multicenter, cohort study to test whether rSO2 predicts neurological outcomes after OHCA. We measured rSO2 in OHCA patients immediately after hospital arrival using a near-infrared spectrometer placed on the forehead with non-blinded fashion. The primary endpoint was "neurological outcomes" at 90 days after OHCA. RESULTS: EMS providers are not permitted to terminate CPR in the field in Japan, and so most patients with OHCA who are treated by EMS personnel are transported to emergency hospitals. Among 1017 OHCA patients, 672 patients including 52 comatosepatients with pulses detectable (8%) and 620 cardiac arrestpatients (92%) at hospital arrival were enrolled prospectively and consecutively. Twenty-nine patients with good neurological outcome had a significantly higher value of rSO2 at hospital arrival than 643 patients with poor neurological outcome (mean [±SD] 55.6±20.8% vs. 19.7±11.0%, p<0.001). Receiver operating curve analysis indicated an optimal rSO2 cutoff point of >42% for predicting good neurological outcome, with sensitivity 0.79 (95% confidence interval [CI], 0.60-0.92), specificity 0.95 (95% CI, 0.93-0.96), positive predictive value, 0.41 (95% CI, 0.28-0.55), negative predictive value, 0.99 (95% CI, 0.98-1.00), and area under the curve 0.90 (95% CI, 0.88-0.92). CONCLUSION: The rSO2 at hospital arrival can predict good neurological outcome at 90 days after OHCA.
Authors: Cornelia Genbrugge; Ingrid Meex; Willem Boer; Frank Jans; René Heylen; Bert Ferdinande; Jo Dens; Cathy De Deyne Journal: Crit Care Date: 2015-03-24 Impact factor: 9.097
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Authors: Christian Storm; Alexander Wutzler; Lars Trenkmann; Alexander Krannich; Sabrina von Rheinbarben; Fridolin Luckenbach; Jens Nee; Natalie Otto; Tim Schroeder; Christoph Leithner Journal: Scand J Trauma Resusc Emerg Med Date: 2016-04-06 Impact factor: 2.953