title: Detection of ROSC in Patients with Cardiac Arrest During Chest Compression Using NIRS: A Pilot Study.
abstract: Return of spontaneous circulation (ROSC) during chest compression is generally detected by arterial pulse palpation and end-tidal CO2 monitoring; however, it is necessary to stop chest compression during pulse palpation, and to perform endotracheal intubation for monitoring end-tidal CO2. In the present study, we evaluated whether near-infrared spectroscopy (NIRS) allows the detection of ROSC during chest compression without interruption. We monitored cerebral blood oxygenation in 19 patients with cardiac arrest using NIRS (NIRO-200NX, Hamamatsu Photonics, Japan). On arrival at the emergency room, the attending physicians immediately assessed whether a patient was eligible for this study after conventional advanced life support (ALS) and employed NIRS to measure cerebral blood oxygenation (CBO) in the bilateral frontal lobe in patients. We found cerebral blood flow waveforms in synchrony with chest compressions in all patients. In addition, we observed abrupt increases of oxy-hemoglobin concentration and tissue oxygen index (TOI), which were associated with ROSC detected by pulse palpation. The present findings indicate that NIRS can be used to assess the quality of chest compression in patients with cardiac arrest as demonstrated by the detection of synchronous waveforms during cardiopulmonary resuscitation (CPR). NIRS appears to be applicable for detection of ROSC without interruption of chest compression and without endotracheal intubation.
authors.affiliation: Department of Cardiology, Nihon University Hospital, 1-6 Kanda Surugadai, Chiyoda-ku, Tokyo, 101-8309, Japan. ygt0108@gmail.com.|Department of Emergency and Critical Care Medicine, Nihon University Hospital, Tokyo, Japan. ygt0108@gmail.com.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Yagi
authors.affiliation: Department of Cardiology, Nihon University Hospital, 1-6 Kanda Surugadai, Chiyoda-ku, Tokyo, 101-8309, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Nagao
authors.affiliation: Department of Emergency and Critical Care Medicine, Nihon University Hospital, Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kawamorita
authors.affiliation: Department of Cardiology, Nihon University Hospital, 1-6 Kanda Surugadai, Chiyoda-ku, Tokyo, 101-8309, Japan.|Department of Emergency and Critical Care Medicine, Nihon University Hospital, Tokyo, Japan.
authors.forename: Taketomo
authors.initials: T
authors.lastname: Soga
authors.affiliation: Department of Emergency and Critical Care Medicine, Nihon University Hospital, Tokyo, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ishii
authors.affiliation: Department of Emergency and Critical Care Medicine, Nihon University Hospital, Tokyo, Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Chiba
authors.affiliation: Department of Cardiology, Nihon University Hospital, 1-6 Kanda Surugadai, Chiyoda-ku, Tokyo, 101-8309, Japan.|Department of Emergency and Critical Care Medicine, Nihon University Hospital, Tokyo, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Cardiology, Nihon University Hospital, 1-6 Kanda Surugadai, Chiyoda-ku, Tokyo, 101-8309, Japan.
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Tani
authors.affiliation: Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Yoshino
authors.affiliation: Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
authors.affiliation: Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan.|NEWCAT Institute, Nihon University College of Engineering, Koriyama, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Sakatani
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000378:metabolism*; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D010865:Pilot Projects; D019265:Spectroscopy, Near-Infrared / Q000379:methods*
chemical_list: D010100:Oxygen
keywords: Cardiac arrest; Cardiopulmonary resuscitation; Near-infrared spectroscopy; Quality of cardiopulmonary resuscitation; Return of spontaneous circulation