Article Text

NON-INVASIVE CEREBRAL OXYGENATION (RSO2) DURING MILD THERAPEUTIC HYPOTHERMIA AND REWARMING
  1. K Horsnell1,
  2. H te Beest1,
  3. D Tibboel1
  1. 1Intensive Care Unit, Erasmus Mc – Sophia Children’s Hospital, Rotterdam, The Netherlands

Abstract

Background Multi-centered studies in adults who were kept hypothermic as brain protective strategy after cardiac arrest and also in newborn babies with perinatal asphyxia have clearly demonstrated that mild hypothermia (32 to 34 degrees C) can improve neurological outcome after post-anoxic injury. This represents a highly promising development in the field of neurocritical care.

Methods Observational study during mild therapeutic hypothermia and rewarming post resuscitation. We induced a rectal temperature of 32 to 34 degrees C for 24 to 48 hours, after which we rewarmed +0,5 degrees C per 2 hours. Real-time regional oxygenation, right and left cerebral cortex of the watershed region, was measured with the INVOS 5100 continuously.

Results 7 patients were measured; 1 patient had a lack of data. Of the 6 remaining patients; 2 patients died, 4 survived. We evaluated the correlation between the mean cerebral oxygen saturation with the temperature of the patient; The survivors had a positive correlation (min.0,561- max. 0,829/ resp. p = 0.007- 0,000) versus the deceased who had a negative correlation (−0,634 and −0,497/ resp p = 0.02 and 0.01).

Conclusions We found a negative versus a positive correlation between cerebral oxygenation and temperature of the patient in resp. deceased patients versus survivors after resuscitation. This suggests an increase of cerebral oxygen supply in survivors during an increasing temperature. Confirmative data will reveal the predictive value for survival of routine rSO2.

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