title: A feasibility study of cerebral oximetry during in-hospital mechanical and manual cardiopulmonary resuscitation*.
abstract: OBJECTIVE
  A major hurdle limiting the ability to improve the quality of resuscitation has been the lack of a noninvasive real-time detection system capable of monitoring the quality of cerebral and other organ perfusion, as well as oxygen delivery during cardiopulmonary resuscitation. Here, we report on a novel system of cerebral perfusion targeted resuscitation.
  
  
  METHODS
  An observational study evaluating the role of cerebral oximetry (Equanox; Nonin, Plymouth, MI, and Invos; Covidien, Mansfield, MA) as a real-time marker of cerebral perfusion and oxygen delivery together with the impact of an automated mechanical chest compression system (Life Stat; Michigan Instruments, Grand Rapids, MI) on oxygen delivery and return of spontaneous circulation following in-hospital cardiac arrest.
  
  
  METHODS
  Tertiary medical center.
  
  
  METHODS
  In-hospital cardiac arrest patients (n = 34).
  
  
  RESULTS
  Cerebral oximetry provided real-time information regarding the quality of perfusion and oxygen delivery. The use of automated mechanical chest compression device (n = 12) was associated with higher regional cerebral oxygen saturation compared with manual chest compression device (n = 22) (53.1% ± 23.4% vs 24% ± 25%, p = 0.002). There was a significant difference in mean regional cerebral oxygen saturation (median % ± interquartile range) in patients who achieved return of spontaneous circulation (n = 15) compared with those without return of spontaneous circulation (n = 19) (47.4% ± 21.4% vs 23% ± 18.42%, p < 0.001). After controlling for patients achieving return of spontaneous circulation or not, significantly higher mean regional cerebral oxygen saturation levels during cardiopulmonary resuscitation were observed in patients who were resuscitated using automated mechanical chest compression device (p < 0.001).
  
  
  CONCLUSIONS
  The integration of cerebral oximetry into cardiac arrest resuscitation provides a novel noninvasive method to determine the quality of cerebral perfusion and oxygen delivery to the brain. The use of automated mechanical chest compression device during in-hospital cardiac arrest may lead to improved oxygen delivery and organ perfusion.
authors.forename: Sam
authors.initials: S
authors.lastname: Parnia
authors.forename: Asad
authors.initials: A
authors.lastname: Nasir
authors.forename: Anna
authors.initials: A
authors.lastname: Ahn
authors.forename: Hanan
authors.initials: H
authors.lastname: Malik
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.forename: Jiawen
authors.initials: J
authors.lastname: Zhu
authors.forename: Francis
authors.initials: F
authors.lastname: Dorazi
authors.forename: Paul
authors.initials: P
authors.lastname: Richman
mesh_terms: D000046:Academic Medical Centers; D000369:Aged, 80 and over; D001921:Brain / Q000378:metabolism*; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006323:Heart Arrest / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010092:Oximetry / Q000295:instrumentation*