Cerebral Oxygen Monitoring Using Cerebral Oximetry
We are the first research group in the U.S. to use cerebral oximetry, a widely available and noninvasive monitoring technology currently used in operating rooms, to measure the amount of oxygen reentering the brain during cardiopulmonary resuscitation (CPR). By analyzing oxygen levels against statistics of survival, we can more precisely assess the optimal levels of oxygen needed for the patient to recover without brain damage. This gives physicians the enormous advantage of measuring the effectiveness of treatment in real time and ultimately tailoring their treatments to ensure effective brain resuscitation and oxygen delivery.
Our pioneering work using cerebral oximetry during cardiac arrest has led to groundbreaking discoveries. In a study carried out across five hospitals in 183 patients during CPR, we demonstrated that higher cerebral oxygenation levels during CPR are significantly associated with higher odds of restarting the heart and a higher chance that a patient will survive and leave the hospital without significant brain damage. Specifically, we demonstrated that while typically brain oxygen levels may be very low, if oxygen levels in the brain reach approximately 60 percent, physicians have a 95 percent chance of restarting the patient’s heart. On the other hand, if brain oxygen levels remain below 25 percent and nothing is done to elevate them, there is almost no chance for the heart to restart.
The clear relationship between cerebral oxygenation and improved patient outcomes shown by our study, which has also been supported by others, has paved the way for a new standard of care.
Our goal moving forward is to further test these results on a large patient cohort to identify the gold standard brain oxygen level that physicians need to target during cardiac arrest and CPR. We plan to increase and refine our data to create a clinical test that can be applied during CPR that indicates the patient’s chances of survival based on various factors, including cerebral oxygenation, while also taking consideration other important factors such as age, severity of illness, and other pertinent medical information. Such a clinical test will empower physicians to make quick decisions about increasing oxygen in the brain in order to optimize survival without brain damage.
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