title: Cerebral oximetry and cerebral blood flow monitoring in 2 pediatric survivors with out-of-hospital cardiac arrest.
abstract: In pediatric out-of-hospital cardiac arrest (POHCA), cardiovascular monitoring tools have improved resuscitative endeavors and cardiovascular outcomes but with still poor neurologic outcomes. Regarding cardiac arrest in patients with congenital heart disease during surgery, the application of cerebral oximetry with blood volume index (BVI) during the resuscitation has shown significant results and prognostic significance. We present 2 POHCA patients who had cerebral oximetry with BVI monitoring during their arrest and postarrest phase in the emergency department and its potential prognostic aspect.Basic procedures include left and right cerebral oximetry with BVI monitoring at every 5-second interval during cardiac arrest, resuscitation, and postarrest in 2 POHCA patients in the pediatric emergency department.Regional cerebral tissue oxygen saturation (rSo2) with BVI readings in these 2 POHCA survivors demonstrated interesting cerebral physiology, blood flow, and potential prognostic outcome. In 1 patient, the reference range of cerebral rSo2 with positive blood flow during arrest and postarrest phases consistently occurred. This neurologic monitoring had its significance when the resuscitation effectiveness was used and end-tidal CO2 changes were lost. The other patient's cerebral rSo2 with simultaneous BVI readings and trending showed the effectiveness of the emergency medical services (EMS) resuscitation.Cerebral oximetry with cerebral blood flow index monitoring in these POHCA survivors demonstrates compelling periarrest and postarrest cerebral physiology information and prognostication. Cerebral oximetry with cerebral BVI monitoring during these arrest phases has potential as a neurologic monitor for the resuscitative intervention's effectiveness and its possible neurologic prognostic application in the pediatric OCHA patients.
authors.affiliation: Department of Pediatrics, Division of Pediatric Emergency Medicine, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Thomas
authors.initials: T
authors.lastname: Abramo
authors.affiliation: Department of Emergency Medicine, Vanderbilt University, Nashville, TN.
authors.forename: Nitin
authors.initials: N
authors.lastname: Aggarwal
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Vanderbilt University, Nashville, TN.
authors.forename: Ian
authors.initials: I
authors.lastname: Kane
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Vanderbilt University, Nashville, TN.
authors.forename: Kristen
authors.initials: K
authors.lastname: Crossman
authors.affiliation: Department of Pediatrics, Division of Pediatric Emergency Medicine, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Mark
authors.initials: M
authors.lastname: Meredith
mesh_terms: D000293:Adolescent; D016887:Cardiopulmonary Resuscitation; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000097:blood* / Q000628:therapy; D010092:Oximetry / Q000379:methods*; D012039:Regional Blood Flow