第46回日本集中治療医学会学術集会

Presentation information

English Session

[EngO4] English Session4

Sat. Mar 2, 2019 9:50 AM - 10:50 AM 第11会場 (国立京都国際会館1F Room C-2)

Chair:Takashi Tagami(Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Japan)

[EngO4-1] Effectiveness of delta Saturation of brain tissue (StO2) in pre-hospital settings: Pilot study

Jumpei Tsukuda, Takeshi Kawaguchi, Seitaro Sugawara, Kentaro Okamoto, Takaki Naito, Takuro Endo, Kenichiro Morisawa, Nobuhiko Shimozawa, Shigeki Fujitani, Yasuhiko Taira (Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Japan)

【Background】
There are no specific indicators to evaluate cardiopulmonary resuscitation (CPR) in the current guidelines. Recently, CPR with near-infrared spectroscopy (NIRS) has been reported to be effective for predicting return of spontaneous circulation (ROSC).
【Objective】
We evaluated whether there exists any association between saturation of brain tissue (StO2) in ambulance and ROSC for out-of-hospital cardiopulmonary arrest (OHCA) patients.
【Methods】
This prospective cohort study was conducted from May 2017. OHCA patients delivered to our emergency department (ED) were divided into 2 groups: ROSC group and Non-ROSC group. We examined the change in StO2 (delta StO2) using a portable NIRS device in ambulance. Delta StO2 was defined as the difference between the initial StO2 first displayed on the monitor in the ambulance and the final StO2 shown on the monitor at the arrival of the patient to the ED (delta StO2 = final StO2 - initial StO2). Although this research is still ongoing, analysis was performed for cases collected from May 2017 to April 2018.
【Results】
Out of 63 patients, 9 were excluded and the remaining 54 patients were classified as follows; 14 in ROSC group and 39 in Non-ROSC group. Patients in ROSC group were significantly younger and more likely to have their event witnessed. Delta StO2 of ROSC group was significantly higher than that of Non-ROSC group (4.1% ± 6.5% vs. 1.1% ± 3.4%, p <0.036).
【Discussion】
Although some studies have evaluated ROSC using delta StO2 in hospital settings, no study has discussed the effectiveness of delta StO2 in pre-hospital settings such as ambulance. CPR using delta StO2 as an indicator for ROSC might be effective in ambulance where only limited devices can be equipped.
【Conclusion】
This study showed that the higher the delta StO2 in ambulance, the higher the ROSC rate. Further research with more cases is warranted.