title: Regional Cerebral Oximetry During Cardiopulmonary Resuscitation: Useful or Useless?
abstract: BACKGROUND
  Approximately 375,000 people annually experience sudden cardiac arrest (CA) in Europe. Most patients who survive the initial hours and days after CA die of postanoxic brain damage. Current monitors, such as electrocardiography and end-tidal capnography, provide only indirect information about the condition of the brain during cardiopulmonary resuscitation (CPR). In contrast, cerebral near-infrared spectroscopy provides continuous, noninvasive, real-time information about brain oxygenation without the need for a pulsatile blood flow. It measures transcutaneous cerebral tissue oxygen saturation (rSO2). This information could supplement currently used monitors. Moreover, an evolution in rSO2 monitoring technology has made it easier to assess rSO2 in CA conditions.
  
  
  OBJECTIVE
  We give an overview of the literature regarding rSO2 measurements during CPR and the current commercially available devices. We highlight the feasibility of cerebral saturation measurement during CPR, its role as a quality parameter of CPR, predictor of return of spontaneous circulation (ROSC) and neurologic outcome, and its monitoring function during transport.
  
  
  CONCLUSIONS
  rSO2 is feasible in the setting of CA and has the potential to measure the quality of CPR, predict ROSC and neurologic outcome, and monitor post-CA patients during transport.
  
  
  CONCLUSIONS
  The literature shows that rSO2 has the potential to serve multiple roles as a neuromonitoring tool during CPR and also to guide neuroprotective therapeutic strategies.
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Genbrugge
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Jo
authors.initials: J
authors.lastname: Dens
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Meex
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Willem
authors.initials: W
authors.lastname: Boer
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
authors.forename: Ward
authors.initials: W
authors.lastname: Eertmans
authors.affiliation: Emergency Department, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Sabbe
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Jans
authors.affiliation: Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
authors.forename: Cathy
authors.initials: C
authors.lastname: De Deyne
mesh_terms: D002545:Brain Ischemia / Q000175:diagnosis*; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005240:Feasibility Studies; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy; D010092:Oximetry / Q000379:methods*; D010100:Oxygen / Q000378:metabolism*; D012039:Regional Blood Flow; D019265:Spectroscopy, Near-Infrared
chemical_list: D010100:Oxygen
keywords: NIRS; advanced life support; cardiac arrest; cardiopulmonary resuscitation; cerebral tissue saturation; neuromonitoring; out-of-hospital cardiac arrest; prehospital