title: Determinants and significance of cerebral oximetry after cardiac arrest: A prospective cohort study.
abstract: OBJECTIVE
  To study the determinants and the evolution of cerebral oximetry determined by near-infrared spectroscopy after out-of-hospital cardiac arrest of cardiac origin during therapeutic hypothermia and rewarming, and to compare cerebral oximetry values between patients with good and bad prognosis.
  
  
  METHODS
  In this prospective, non-interventional, single center study, all consecutive patients between 18 and 80 years admitted for out-of-hospital cardiac arrest (OHCA) with a no flow less than 10min, a low flow of less than 50min and a persistent coma after ROSC with Glasgow score equal or less than seven at baseline were included.
  
  
  RESULTS
  Between February 2012 and January 2013, 43 patients were admitted for OHCA in our ICU. Twenty-two patients (51%) were discharged with no or minimal neurologic complications (CPC 1-2). Mortality rate in the ICU was 46.5%. Cerebral oximetry (rSO2) was correlated with temperature, heart rhythm, PaO2, hemoglobin, and mean arterial pressure. Mean rSO2 during the 48 first hours was not different between patients with good and bad neurologic outcomes, respectively, 61.8 (5.9) vs. 58.1 (8.8), P=0.13, as during the period of hypothermia. The minimal value of rSO2 during the first 48h was significantly different between patients with good prognosis and those with bad prognosis, respectively, 45.0 (6.8) vs. 31.7 (15.0), P=0.0009.
  
  
  CONCLUSIONS
  In this prospective cohort of OHCA patients, main determinants of rSO2 were systemic variables. Monitoring of rSO2 does not allow discriminating patients with good or bad outcome, but could be useful for identifying vulnerable periods for the development of neurologic injury.
authors.affiliation: Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France.
authors.forename: Adrien
authors.initials: A
authors.lastname: Bouglé
authors.affiliation: Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Daviaud
authors.affiliation: Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France; INSERM UMR-S970, Paris Cardiovascular Research Center, Paris, France.
authors.forename: Wulfran
authors.initials: W
authors.lastname: Bougouin
authors.affiliation: Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors.forename: Aurore
authors.initials: A
authors.lastname: Rodrigues
authors.affiliation: Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France; INSERM UMR-S970, Paris Cardiovascular Research Center, Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Geri
authors.affiliation: Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France.
authors.forename: Tristan
authors.initials: T
authors.lastname: Morichau-Beauchant
authors.affiliation: INSERM UMR-S970, Paris Cardiovascular Research Center, Paris, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Lamhaut
authors.affiliation: Emergency Department, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; INSERM UMR-S970, Paris Cardiovascular Research Center, Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Dumas
authors.affiliation: Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France; INSERM UMR-S970, Paris Cardiovascular Research Center, Paris, France. Electronic address: alain.cariou@aphp.fr.
authors.forename: Alain
authors.initials: A
authors.lastname: Cariou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002560:Cerebrovascular Circulation; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000097:blood*; D010092:Oximetry; D011446:Prospective Studies; D055815:Young Adult
keywords: Cerebral oximetry; Hypothermia; Out-of-hospital cardiac arrest