University of Hertfordshire

Cerebral Oximetry During Cardiac Arrest: A Multicenter Study of Neurologic Outcomes and Survival

Research output: Contribution to journalArticlepeer-review

Standard

Cerebral Oximetry During Cardiac Arrest: A Multicenter Study of Neurologic Outcomes and Survival. / Parnia, Sam; Yang, Jie; Nguyen, Robert; Ahn, Anna; Zhu, Jiawen; Inigo-Santiago, Loren; Nasir, Asad; Golder, Kim ; Ravishankar, Shreyas; Bartlett, Pauline ; Xu, Jianjin ; Pogson, David; Walker, Christopher; Cooke, Sarah; Spearpoint, Ken; Kitson, David; Melody, Teresa; Chilwan, Mehboob; Schoenfeld, Elinor; Richman, Paul; Mills, Barbara; Wichtendahl, Nancy; Nolan, Jerry; Singer, Adam; Brett, Stephen; Perkins, Gavin; Deakin, Charles.

In: Critical Care Medicine, Vol. 44, No. 9, 01.09.2016, p. 1663-1674.

Research output: Contribution to journalArticlepeer-review

Harvard

Parnia, S, Yang, J, Nguyen, R, Ahn, A, Zhu, J, Inigo-Santiago, L, Nasir, A, Golder, K, Ravishankar, S, Bartlett, P, Xu, J, Pogson, D, Walker, C, Cooke, S, Spearpoint, K, Kitson, D, Melody, T, Chilwan, M, Schoenfeld, E, Richman, P, Mills, B, Wichtendahl, N, Nolan, J, Singer, A, Brett, S, Perkins, G & Deakin, C 2016, 'Cerebral Oximetry During Cardiac Arrest: A Multicenter Study of Neurologic Outcomes and Survival', Critical Care Medicine, vol. 44, no. 9, pp. 1663-1674. https://doi.org/10.1097/CCM.0000000000001723

APA

Parnia, S., Yang, J., Nguyen, R., Ahn, A., Zhu, J., Inigo-Santiago, L., Nasir, A., Golder, K., Ravishankar, S., Bartlett, P., Xu, J., Pogson, D., Walker, C., Cooke, S., Spearpoint, K., Kitson, D., Melody, T., Chilwan, M., Schoenfeld, E., ... Deakin, C. (2016). Cerebral Oximetry During Cardiac Arrest: A Multicenter Study of Neurologic Outcomes and Survival. Critical Care Medicine, 44(9), 1663-1674. https://doi.org/10.1097/CCM.0000000000001723

Vancouver

Author

Parnia, Sam ; Yang, Jie ; Nguyen, Robert ; Ahn, Anna ; Zhu, Jiawen ; Inigo-Santiago, Loren ; Nasir, Asad ; Golder, Kim ; Ravishankar, Shreyas ; Bartlett, Pauline ; Xu, Jianjin ; Pogson, David ; Walker, Christopher ; Cooke, Sarah ; Spearpoint, Ken ; Kitson, David ; Melody, Teresa ; Chilwan, Mehboob ; Schoenfeld, Elinor ; Richman, Paul ; Mills, Barbara ; Wichtendahl, Nancy ; Nolan, Jerry ; Singer, Adam ; Brett, Stephen ; Perkins, Gavin ; Deakin, Charles. / Cerebral Oximetry During Cardiac Arrest: A Multicenter Study of Neurologic Outcomes and Survival. In: Critical Care Medicine. 2016 ; Vol. 44, No. 9. pp. 1663-1674.

Bibtex

@article{8cc1abc1146843b8a4441ab09c036e1d,
title = "Cerebral Oximetry During Cardiac Arrest: A Multicenter Study of Neurologic Outcomes and Survival",
abstract = "Objectives: Cardiac arrest is associated with morbidity and mortality because of cerebral ischemia. Therefore, we tested the hypothesis that higher regional cerebral oxygenation during resuscitation is associated with improved return of spontaneous circulation, survival, and neurologic outcomes at hospital discharge. We further examined the validity of regional cerebral oxygenation as a test to predict these outcomes. Design: Multicenter prospective study of in-hospital cardiac arrest. Setting: Five medical centers in the United States and the United Kingdom. Patients: Inclusion criteria are as follows: in-hospital cardiac arrest, age 18 years old or older, and prolonged cardiopulmonary resuscitation greater than or equal to 5 minutes. Patients were recruited consecutively during working hours between August 2011 and September 2014. Survival with a favorable neurologic outcome was defined as a cerebral performance category 1–2. Interventions: Cerebral oximetry monitoring. Measurements and Main Results: Among 504 in-hospital cardiac arrest events, 183 (36%) met inclusion criteria. Overall, 62 of 183 (33.9%) achieved return of spontaneous circulation, whereas 13 of 183 (7.1%) achieved cerebral performance category 1–2 at discharge. Higher mean ± sd regional cerebral oxygenation was associated with return of spontaneous circulation versus no return of spontaneous circulation (51.8% ± 11.2% vs 40.9% ± 12.3%) and cerebral performance category 1–2 versus cerebral performance category 3–5 (56.1% ± 10.0% vs 43.8% ± 12.8%) (both p < 0.001). Mean regional cerebral oxygenation during the last 5 minutes of cardiopulmonary resuscitation best predicted the return of spontaneous circulation (area under the curve, 0.76; 95% CI, 0.69–0.83); regional cerebral oxygenation greater than or equal to 25% provided 100% sensitivity (95% CI, 94–100) and 100% negative predictive value (95% CI, 79–100); regional cerebral oxygenation greater than or equal to 65% provided 99% specificity (95% CI, 95–100) and 93% positive predictive value (95% CI, 66–100) for return of spontaneous circulation. Time with regional cerebral oxygenation greater than 50% during cardiopulmonary resuscitation best predicted cerebral performance category 1–2 (area under the curve, 0.79; 95% CI, 0.70–0.88). Specifically, greater than or equal to 60% cardiopulmonary resuscitation time with regional cerebral oxygenation greater than 50% provided 77% sensitivity (95% CI,:46–95), 72% specificity (95% CI, 65–79), and 98% negative predictive value (95% CI, 93–100) for cerebral performance category 1–2. Conclusions: Cerebral oximetry allows real-time, noninvasive cerebral oxygenation monitoring during cardiopulmonary resuscitation. Higher cerebral oxygenation during cardiopulmonary resuscitation is associated with return of spontaneous circulation and neurologically favorable survival to hospital discharge. Achieving higher regional cerebral oxygenation during resuscitation may optimize the chances of cardiac arrest favorable outcome",
author = "Sam Parnia and Jie Yang and Robert Nguyen and Anna Ahn and Jiawen Zhu and Loren Inigo-Santiago and Asad Nasir and Kim Golder and Shreyas Ravishankar and Pauline Bartlett and Jianjin Xu and David Pogson and Christopher Walker and Sarah Cooke and Ken Spearpoint and David Kitson and Teresa Melody and Mehboob Chilwan and Elinor Schoenfeld and Paul Richman and Barbara Mills and Nancy Wichtendahl and Jerry Nolan and Adam Singer and Stephen Brett and Gavin Perkins and Charles Deakin",
year = "2016",
month = sep,
day = "1",
doi = "10.1097/CCM.0000000000001723",
language = "English",
volume = "44",
pages = "1663--1674",
journal = "Critical Care Medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins Ltd.",
number = "9",

}

RIS

TY - JOUR

T1 - Cerebral Oximetry During Cardiac Arrest: A Multicenter Study of Neurologic Outcomes and Survival

AU - Parnia, Sam

AU - Yang, Jie

AU - Nguyen, Robert

AU - Ahn, Anna

AU - Zhu, Jiawen

AU - Inigo-Santiago, Loren

AU - Nasir, Asad

AU - Golder, Kim

AU - Ravishankar, Shreyas

AU - Bartlett, Pauline

AU - Xu, Jianjin

AU - Pogson, David

AU - Walker, Christopher

AU - Cooke, Sarah

AU - Spearpoint, Ken

AU - Kitson, David

AU - Melody, Teresa

AU - Chilwan, Mehboob

AU - Schoenfeld, Elinor

AU - Richman, Paul

AU - Mills, Barbara

AU - Wichtendahl, Nancy

AU - Nolan, Jerry

AU - Singer, Adam

AU - Brett, Stephen

AU - Perkins, Gavin

AU - Deakin, Charles

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Objectives: Cardiac arrest is associated with morbidity and mortality because of cerebral ischemia. Therefore, we tested the hypothesis that higher regional cerebral oxygenation during resuscitation is associated with improved return of spontaneous circulation, survival, and neurologic outcomes at hospital discharge. We further examined the validity of regional cerebral oxygenation as a test to predict these outcomes. Design: Multicenter prospective study of in-hospital cardiac arrest. Setting: Five medical centers in the United States and the United Kingdom. Patients: Inclusion criteria are as follows: in-hospital cardiac arrest, age 18 years old or older, and prolonged cardiopulmonary resuscitation greater than or equal to 5 minutes. Patients were recruited consecutively during working hours between August 2011 and September 2014. Survival with a favorable neurologic outcome was defined as a cerebral performance category 1–2. Interventions: Cerebral oximetry monitoring. Measurements and Main Results: Among 504 in-hospital cardiac arrest events, 183 (36%) met inclusion criteria. Overall, 62 of 183 (33.9%) achieved return of spontaneous circulation, whereas 13 of 183 (7.1%) achieved cerebral performance category 1–2 at discharge. Higher mean ± sd regional cerebral oxygenation was associated with return of spontaneous circulation versus no return of spontaneous circulation (51.8% ± 11.2% vs 40.9% ± 12.3%) and cerebral performance category 1–2 versus cerebral performance category 3–5 (56.1% ± 10.0% vs 43.8% ± 12.8%) (both p < 0.001). Mean regional cerebral oxygenation during the last 5 minutes of cardiopulmonary resuscitation best predicted the return of spontaneous circulation (area under the curve, 0.76; 95% CI, 0.69–0.83); regional cerebral oxygenation greater than or equal to 25% provided 100% sensitivity (95% CI, 94–100) and 100% negative predictive value (95% CI, 79–100); regional cerebral oxygenation greater than or equal to 65% provided 99% specificity (95% CI, 95–100) and 93% positive predictive value (95% CI, 66–100) for return of spontaneous circulation. Time with regional cerebral oxygenation greater than 50% during cardiopulmonary resuscitation best predicted cerebral performance category 1–2 (area under the curve, 0.79; 95% CI, 0.70–0.88). Specifically, greater than or equal to 60% cardiopulmonary resuscitation time with regional cerebral oxygenation greater than 50% provided 77% sensitivity (95% CI,:46–95), 72% specificity (95% CI, 65–79), and 98% negative predictive value (95% CI, 93–100) for cerebral performance category 1–2. Conclusions: Cerebral oximetry allows real-time, noninvasive cerebral oxygenation monitoring during cardiopulmonary resuscitation. Higher cerebral oxygenation during cardiopulmonary resuscitation is associated with return of spontaneous circulation and neurologically favorable survival to hospital discharge. Achieving higher regional cerebral oxygenation during resuscitation may optimize the chances of cardiac arrest favorable outcome

AB - Objectives: Cardiac arrest is associated with morbidity and mortality because of cerebral ischemia. Therefore, we tested the hypothesis that higher regional cerebral oxygenation during resuscitation is associated with improved return of spontaneous circulation, survival, and neurologic outcomes at hospital discharge. We further examined the validity of regional cerebral oxygenation as a test to predict these outcomes. Design: Multicenter prospective study of in-hospital cardiac arrest. Setting: Five medical centers in the United States and the United Kingdom. Patients: Inclusion criteria are as follows: in-hospital cardiac arrest, age 18 years old or older, and prolonged cardiopulmonary resuscitation greater than or equal to 5 minutes. Patients were recruited consecutively during working hours between August 2011 and September 2014. Survival with a favorable neurologic outcome was defined as a cerebral performance category 1–2. Interventions: Cerebral oximetry monitoring. Measurements and Main Results: Among 504 in-hospital cardiac arrest events, 183 (36%) met inclusion criteria. Overall, 62 of 183 (33.9%) achieved return of spontaneous circulation, whereas 13 of 183 (7.1%) achieved cerebral performance category 1–2 at discharge. Higher mean ± sd regional cerebral oxygenation was associated with return of spontaneous circulation versus no return of spontaneous circulation (51.8% ± 11.2% vs 40.9% ± 12.3%) and cerebral performance category 1–2 versus cerebral performance category 3–5 (56.1% ± 10.0% vs 43.8% ± 12.8%) (both p < 0.001). Mean regional cerebral oxygenation during the last 5 minutes of cardiopulmonary resuscitation best predicted the return of spontaneous circulation (area under the curve, 0.76; 95% CI, 0.69–0.83); regional cerebral oxygenation greater than or equal to 25% provided 100% sensitivity (95% CI, 94–100) and 100% negative predictive value (95% CI, 79–100); regional cerebral oxygenation greater than or equal to 65% provided 99% specificity (95% CI, 95–100) and 93% positive predictive value (95% CI, 66–100) for return of spontaneous circulation. Time with regional cerebral oxygenation greater than 50% during cardiopulmonary resuscitation best predicted cerebral performance category 1–2 (area under the curve, 0.79; 95% CI, 0.70–0.88). Specifically, greater than or equal to 60% cardiopulmonary resuscitation time with regional cerebral oxygenation greater than 50% provided 77% sensitivity (95% CI,:46–95), 72% specificity (95% CI, 65–79), and 98% negative predictive value (95% CI, 93–100) for cerebral performance category 1–2. Conclusions: Cerebral oximetry allows real-time, noninvasive cerebral oxygenation monitoring during cardiopulmonary resuscitation. Higher cerebral oxygenation during cardiopulmonary resuscitation is associated with return of spontaneous circulation and neurologically favorable survival to hospital discharge. Achieving higher regional cerebral oxygenation during resuscitation may optimize the chances of cardiac arrest favorable outcome

U2 - 10.1097/CCM.0000000000001723

DO - 10.1097/CCM.0000000000001723

M3 - Article

VL - 44

SP - 1663

EP - 1674

JO - Critical Care Medicine

JF - Critical Care Medicine

SN - 0090-3493

IS - 9

ER -