Scientific Reports (Feb 2021)

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

  • Tiffany S. Ko,
  • Constantine D. Mavroudis,
  • Ryan W. Morgan,
  • Wesley B. Baker,
  • Alexandra M. Marquez,
  • Timothy W. Boorady,
  • Mahima Devarajan,
  • Yuxi Lin,
  • Anna L. Roberts,
  • William P. Landis,
  • Kobina Mensah-Brown,
  • Vinay M. Nadkarni,
  • Robert A. Berg,
  • Robert M. Sutton,
  • Arjun G. Yodh,
  • Daniel J. Licht,
  • Wensheng Guo,
  • Todd J. Kilbaugh

DOI
https://doi.org/10.1038/s41598-021-83270-5
Journal volume & issue
Vol. 11, no. 1
pp. 1 – 14

Abstract

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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 (< 10 min), were assessed by the weighted Youden index (Jw, 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 < 0.01) after 10 min of CPR. Change in [HbO2] 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.