Non-invasive diffuse optical neuromonitoring during cardiopulmonary resuscitation predicts return of spontaneous circulation

• Published in: Scientific reports Vol. 11; no. 1; pp. 3828 - 14
• Main Authors: Ko, Tiffany S., Mavroudis, Constantine D., Morgan, Ryan W., Baker, Wesley B., Marquez, Alexandra M., Boorady, Timothy W., Devarajan, Mahima, Lin, Yuxi, Roberts, Anna L., Landis, William P., Mensah-Brown, Kobina, Nadkarni, Vinay M., Berg, Robert A., Sutton, Robert M., Yodh, Arjun G., Licht, Daniel J., Guo, Wensheng, Kilbaugh, Todd J.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 15.02.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 639/166/985; 692/308/2778; 692/308/3187; 692/308/53/2423; 692/308/575; Animals; Biomarkers; Brain - blood supply; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - methods; Cerebral blood flow; Cerebrovascular Circulation; Clinical Decision-Making; CPR; Disease Management; Disease Models, Animal; Feasibility studies; Heart; Heart Arrest - etiology; Heart Arrest - therapy; Hemodynamics; Hemoglobin; Humanities and Social Sciences; Male; Morbidity; multidisciplinary; Optical properties; Pediatrics; Predictions; Return of Spontaneous Circulation; Scattering coefficient; Science; Science (multidisciplinary); Spectroscopy; Spectrum Analysis - methods; Swine; Translational Research, Biomedical
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-83270-5

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 ([HbO 2 ], [Hb]), oxygen saturation (StO 2 ) 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 (< 10 min), were assessed by the weighted Youden index (J 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), [HbO 2 ], StO 2 and THC from baseline were significantly different in ROSC versus No-ROSC subjects ( p  < 0.01) after 10 min of CPR. Change in [HbO 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.