title: Increase in cerebral oxygenation during advanced life support in out-of-hospital patients is associated with return of spontaneous circulation.
abstract: BACKGROUND
  By maintaining sufficient cerebral blood flow and oxygenation, the goal of cardiopulmonary resuscitation (CPR) is to preserve the pre-arrest neurological state. To date, cerebral monitoring abilities during CPR have been limited. Therefore, we investigated the time-course of cerebral oxygen saturation values (rSO₂) during advanced life support in out-of-hospital cardiac arrest. Our primary aim was to compare rSO₂ values during advanced life support from patients with return of spontaneous circulation (ROSC) to patients who did not achieve ROSC.
  
  
  METHODS
  We performed an observational study to measure rSO₂ using Equanox (Nonin, Plymouth, MI) from the start of advanced life support in the pre-hospital setting.
  
  
  RESULTS
  rSO₂ of 49 consecutive out-of-hospital cardiac arrest patients were analyzed. The total increase from initial rSO₂ value until two minutes before ROSC or end of advanced life support efforts was significantly larger in the group with ROSC 16% (9 to 36) compared to the patients without ROSC 10% (4 to 15) (P = 0.02). Mean rSO₂ from the start of measurement until two minutes before ROSC or until termination of advanced life support was higher in patients with ROSC than in those without, namely 39% ± 7 and 31% ± 4 (P = 0.05) respectively.
  
  
  CONCLUSIONS
  During pre-hospital advanced life support, higher increases in rSO₂ are observed in patients attaining ROSC, even before ROSC was clinically determined. Our findings suggest that rSO₂ could be used in the future to guide patient tailored treatment during cardiac arrest and could therefore be a surrogate marker of the systemic oxygenation state of the patient.
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium. cornelia.genbrugge@uhasselt.be.|Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium. cornelia.genbrugge@uhasselt.be.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Genbrugge
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium. ingrid.meex@uhasselt.be.|Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium. ingrid.meex@uhasselt.be.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Meex
authors.affiliation: Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium. willem.boer@zol.be.
authors.forename: Willem
authors.initials: W
authors.lastname: Boer
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium. frank.jans@zol.be.|Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium. frank.jans@zol.be.
authors.forename: Frank
authors.initials: F
authors.lastname: Jans
authors.affiliation: Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium. rene.heylen@zol.be.
authors.forename: René
authors.initials: R
authors.lastname: Heylen
authors.affiliation: Department of Cardiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk, Belgium. bert.ferdinande@zol.be.
authors.forename: Bert
authors.initials: B
authors.lastname: Ferdinande
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium. jo.dens@zol.be.|Department of Cardiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk, Belgium. jo.dens@zol.be.
authors.forename: Jo
authors.initials: J
authors.lastname: Dens
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium. Cathy.dedeyne@zol.be.|Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg Genk, Schiepse Bos 6, 3600, Genk, Belgium. Cathy.dedeyne@zol.be.
authors.forename: Cathy
authors.initials: C
authors.lastname: De Deyne
mesh_terms: D001921:Brain / Q000098:blood supply*; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004632:Emergency Medical Services; D006801:Humans; D008991:Monitoring, Physiologic / Q000295:instrumentation; D058687:Out-of-Hospital Cardiac Arrest / Q000503:physiopathology / Q000628:therapy*; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D012119:Respiration
chemical_list: D010100:Oxygen