title: Load-distributing-band cardiopulmonary resuscitation for out-of-hospital cardiac arrest increases regional cerebral oxygenation: a single-center prospective pilot study.
abstract: BACKGROUND
  Despite advances in therapeutic strategies and improved guidelines, morbidity and mortality rates for out-of-hospital cardiac arrest (OHCA) remain high. Especially, neurological prognosis is one of the most important problems even though brain protection therapy for patients with OHCA has improved greatly in recent years due to the development of emergency post-cardiac arrest interventions such as mild therapeutic hypothermia, early percutaneous coronary intervention, and extracorporeal cardiopulmonary resuscitation (CPR). Recently, cerebral regional oxygen saturation (rSO2) has received attention as a method for evaluation of cerebral oxygenation. We have reported that conventional chest compression did not improve the rSO2 of cardiac arrest patients if they did not achieve return of spontaneous circulation. It is, however, unclear whether a mechanical CPR device is helpful in improving rSO2. The purpose of this study was to evaluate the effects of load-distributing-band CPR (LDB-CPR) on rSO2.
  
  
  METHODS
  In this prospective study, LDB-CPR was begun for OHCA with the AutoPulse(TM) device on patient arrival at hospital. During mechanical CPR, rSO2 values were recorded continuously from the forehead of the patients. CPR for patients with OHCA was performed according to the Japan Resuscitation Council Guidelines 2010 except for using the AutoPulse(TM) instead of manual chest compression.
  
  
  RESULTS
  From December 2012 to December 2013, 34 patients (mean age, 75.6 ± 12.8 years) with OHCA were included in this study. Duration of time from recognition of cardiac collapse to arrival to hospital was 31.0 ± 11.4 min. Compared with the rSO2 value of 38.9 ± 0.7 % prior to starting LDB-CPR, rSO2 values at 4, 8 and 12 minutes increased significantly after initiation of LDB-CPR (44.0 ± 0.9 %, 45.2 ± 0.8 %, and 45.5 ± 0.8 %, respectively, p < 0.05).
  
  
  CONCLUSIONS
  LDB-CPR significantly increased the rSO2 of cardiac arrest patients during resuscitation.
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan. yoshi.ogawa@hp-emerg.med.osaka-u.ac.jp.
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan. shiozaki@hp-emerg.med.osaka-u.ac.jp.
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Shiozaki
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan. htomoya1979@hp-emerg.med.osaka-u.ac.jp.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Hirose
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan. mohnishi@hp-emerg.med.osaka-u.ac.jp.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Ohnishi
authors.affiliation: Department of Emergency and Critical Care Medicine, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka, 570-8507, Japan. 99nakamori@gmail.com.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Nakamori
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan. ogura@hp-emerg.med.osaka-u.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogura
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan. shimazu@hp-emerg.med.osaka-u.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimazu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000401:mortality; D002560:Cerebrovascular Circulation / Q000502:physiology*; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D010092:Oximetry / Q000379:methods; D010101:Oxygen Consumption / Q000502:physiology*; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome