Non-invasive diffuse optical neuromonitoring during cardiopulmonary resuscitation predicts return of spontaneous circulation
Abstract
Neurologic injury is a leading cause of morbidity and mortality following pediatric cardiac arrest. In this study, we assess the feasibility of quantitative, non-invasive, frequency-domain diffuse optical spectroscopy (FD-DOS) neuromonitoring during cardiopulmonary resuscitation (CPR), and its predictive utility for return of spontaneous circulation (ROSC) in an established pediatric swine model of cardiac arrest. Cerebral tissue optical properties, oxy- and deoxy-hemoglobin concentration ([HbO2], [Hb]), oxygen saturation (StO2) and total hemoglobin concentration (THC) were measured by a FD-DOS probe placed on the forehead in 1-month-old swine (8–11 kg; n = 52) during seven minutes of asphyxiation followed by twenty minutes of CPR. ROSC prediction and time-dependent performance of prediction throughout early CPR (w, w = 0.1) with tenfold cross-validation. FD-DOS CPR data was successfully acquired in 48/52 animals; 37/48 achieved ROSC. Changes in scattering coefficient (785 nm), [HbO2], StO2 and THC from baseline were significantly different in ROSC versus No-ROSC subjects (p 2] of + 1.3 µmol/L from 1-min of CPR achieved the highest weighted Youden index (0.96) for ROSC prediction. We demonstrate feasibility of quantitative, non-invasive FD-DOS neuromonitoring, and stable, specific, early ROSC prediction from the third minute of CPR.
Document Details
- Document Type
- Pub Defense Publication
- Publication Date
- Feb 15, 2021
- Source ID
- 10.1038/s41598-021-83270-5
Entities
People
- Alexandra M. Marquez
- Anna L. Roberts
- Arjun Yodh
- Constantine D. Mavroudis
- Daniel J. Licht
- Kobina Mensah-brown
- Mahima Devarajan
- Robert A. Berg
- Robert M. Sutton
- Ryan W Morgan
- Tiffany S. Ko
- Timothy W. Boorady
- Todd J. Kilbaugh
- Vinay M. Nadkarni
- Wensheng Guo
- Wesley B. Baker
- William P. Landis
- Yuxi Lin
Organizations
- Children's Hospital of Philadelphia
- June and Steve Wolfson Family Foundation
- National Institutes of Health
- United States Department of Defense