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Background  In recent years, the measurement of cerebral regional oxygen saturation (rSO 2 ) during resuscitation has attracted attention. The objective of this study was to clarify the relationship between the serial changes in the cerebral rSO 2  values during extracorporeal cardiopulmonary resuscitation (ECPR) and the neurological outcome.    Methods  We measured the serial changes in the cerebral rSO 2  values of patients with out-of-hospital cardiac arrest before and after ECPR in Osaka National Hospital.    Results  From January 2013 through March 2015, the serial changes in the cerebral rSO 2  values were evaluated in 16 patients. Their outcomes, as measured by the Glasgow Outcome Scale (GOS) score at discharge, included good recovery (GR) ( n  = 4), vegetative state (VS) ( n  = 2), and death (D) ( n  = 10). In the poor neurological group (VS and D:  n  = 12; age, 52.8 ± 4.0 years), the cerebral rSO 2  values showed a significant increase during ECPR (5 min before ECPR: 52.0 ± 1.8%; 2 min before ECPR: 56.1 ± 2.3%; 2 min after ECPR: 63.5 ± 2.2%; 5 min after ECPR: 66.4 ± 2.2%; 10 min after ECPR: 67.6 ± 2.3% [ P  < 0.01]). In contrast, in the good neurological group (GR:  n  = 4; age, 53.8 ± 6.9 years), the cerebral rSO 2  values did not increase to a significant extent during ECPR (5 min before ECPR: 61.9 ± 3.1%; 2 min before ECPR: 57.1 ± 4.0%; 2 min after ECPR: 59.6 ± 3.8%; 5 min after ECPR: 61.0 ± 3.7%; 10 min after ECPR: 62.0 ± 3.8% [ P  = 0.88]). Our study suggested that the patients whose cerebral rSO 2  values showed no significant improvement after ECPR might have had a good neurological prognosis.    Conclusions  The serial changes in the cerebral rSO 2  values during ECPR may predict a patient’s neurological outcome. The further evaluation of the validity of rSO 2  monitoring during ECPR may lead to a new resuscitation strategy.

journal of intensive care

The relationship between cerebral regional oxygen saturation during extracorporeal cardiopulmonary resuscitation and the neurological outcome in a retrospective analysis of 16 cases