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Characteristics of jugular bulb oxygen saturationin patients after cardiac arrest: A prospective study
Department of Surgical Sciences - Anaestesiology & Intensive Care, Uppsala University, Uppsala Sweden.ORCID iD: 0000-0003-2492-8666
Department of Surgical Sciences - Anaestesiology & Intensive Care, Uppsala University, Uppsala Sweden.
Department of Surgical Sciences - Anaestesiology & Intensive Care, Uppsala University, Uppsala Sweden.
Department of Surgical Sciences - Anaestesiology & Intensive Care, Uppsala University, Uppsala Sweden.
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2018 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 62, no 9, p. 1237-1245Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Using cerebral oxygen venous saturation post-cardiac arrest (CA) is limited because of a small sample size and prior to establishment of target temperature management (TTM). We aimed to describe variations in jugular bulb oxygen saturation during intensive care in relation to neurological outcome at 6 months post- CA in cases where TTM 33°C was applied.

METHOD:

Prospective observational study in patients over 18 years, comatose immediately after resuscitation from CA. Patients were treated with TTM 33°C M and received a jugular bulb catheter within the first 26 hours post-CA. Neurological outcome was assessed at 6 months using the Cerebral Performance Categories (CPC) and dichotomized into good (CPC 1-2) and poor outcome (CPC 3-5).

RESULTS:

Seventy-five patients were included and 37 (49%) patients survived with a good outcome at 6 months post-CA. No differences were found between patients with good outcome and poor outcome in jugular bulb oxygen saturation. Higher values were seen in differences in oxygen content between central venous oxygen saturation and jugular bulb oxygen saturation in patients with good outcome compared to patients with poor outcome at 6 hours (12 [8-21] vs 5 [-0.3 to 11]% P = .001) post-CA. Oxygen extraction fraction from the brain illustrated lower values in patients with poor outcome compared to patients with good outcome at 96 hours (14 [9-23] vs 31 [25-34]% P = .008).

CONCLUSIONS:

Oxygen delivery and extraction differed in patients with a good outcome compared to those with a poor outcome at single time points. Based on the present findings, the usefulness of jugular bulb oxygen saturation for prognostic purposes is uncertain in patients treated with TTM 33°C post-CA.

Place, publisher, year, edition, pages
2018. Vol. 62, no 9, p. 1237-1245
Keywords [en]
cardiac arrest, intensive care, jugular bulb saturation, neurological outcome, prognostication, target temperature management
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:hig:diva-26622DOI: 10.1111/aas.13162ISI: 000443673500008PubMedID: 29797705Scopus ID: 2-s2.0-85047479161OAI: oai:DiVA.org:hig-26622DiVA, id: diva2:1209999
Note

Funding: Department of Surgical Sciences-Anaesthesiology & Intensive Care, Uppsala University, Sweden

Available from: 2018-05-25 Created: 2018-05-25 Last updated: 2018-09-24Bibliographically approved

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Kristofferzon, Marja-Leena

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