TY - JOUR 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 t AU - Parnia,S AU - Yang,J AU - Nguyen,R AU - Ahn,A AU - Zhu,J AU - Inigo-Santiago,L AU - Nasir,A AU - Golder,K AU - Ravishankar,S AU - Bartlett,P AU - Xu,J AU - Pogson,D AU - Cooke,S AU - Walker,C AU - Spearpoint,K AU - Kitson,D AU - Melody,T AU - Chilwan,M AU - Schoenfeld,E AU - Richman,P AU - Mills,B AU - Wichtendahl,N AU - Nolan,J AU - Singer,A AU - Brett,S AU - Perkins,GD AU - Deakin,CD DO - 10.1097/CCM.0000000000001723 EP - 1674 PY - 2016/// SN - 0090-3493 SP - 1663 TI - Cerebral oximetry during cardiac arrest: a multicenter study of neurologic outcomes and survival T2 - Critical Care Medicine UR - http://dx.doi.org/10.1097/CCM.0000000000001723 UR - http://hdl.handle.net/10044/1/32485 VL - 44 ER -