Arterial and Venous Pressure Monitoring during Cardiopulmonary Resuscitation for Out-of-Hospital Arrests: Four Case Reports

Abstract

Background: A new physiological monitoring system that simultaneously measures femoral arterial pressure, femoral venous pressure, and cerebral tissue oxygen saturation during CPR was used to evaluate the quality of cardiopulmonary resuscitation. In this case report, we would like to present four representative cases with this physiological monitoring system during CPR. Cases: We invasively measured femoral arterial pressure and femoral venous pressure if catheters were immediately inserted into the femoral artery and femoral vein for potential candidates who required extracorporeal cardiopulmonary resuscitation but did not receive such interventions. We presented several cases, including two cases in which cardiopulmonary resuscitation resulted in higher femoral arterial pressure compared to femoral venous pressure, an upward trend in cerebral tissue oxygen saturation values was observed, and both instances achieved the return of spontaneous circulation. In contrast, we also presented two patients with significant increases in femoral venous pressure and low cerebral tissue oxygen saturation values. In both cases, the return of spontaneous circulation was not achieved. Conclusions: We presented cases in which the femoral venous pressure exceeded the femoral arterial pressure using a simultaneous physiological monitoring system to monitor arterial pressure, venous pressure, and cerebral tissue oxygen saturation during cardiopulmonary resuscitation. Further case accumulations will be necessary to assess the variations in hemodynamic status during cardiopulmonary resuscitation and the association between each hemodynamic status and outcomes after cardiac arrest.

Keywords

• out-of-hospital cardiac arrest
• physiological monitoring
• blood pressure
• near-infrared spectroscopy