Background

We performed a retrospective analysis of our earlier study on cerebral oxygenation monitoring by jugular venous oximetry (SjvO₂) in patients of out-of-hospital cardiac arrest (OHCA). The study was focused on high SjvO₂ values (≥ 75%) and their association with neurological outcomes and serum neuron-specific enolase (NSE) concentration.

Method

Forty OHCA patients were divided into (i) high (Group I), (ii) normal (Group II), and (iii) low (Group III) SjvO₂, with the mean SjvO₂ ≥75%, 55–74% and <55% respectively. The neurological outcome was evaluated using the Cerebral Performance Category scale (CPC) on the 90th day after cardiac arrest (post-CA). NSE concentration was determined after ICU admission and then at 24, 48, and 72 hours (h) post-CA.

Results

High mean SjvO₂ occurred in 67% of patients, while no patients had low mean SjvO₂. The unfavourable outcome was significantly more common in Group I than Group II (74% versus 23%, p < 0.01). Group I patients had significantly higher median NSE than Group II at 48 and 72 h post-CA. A positive correlation was found between SjvO₂ and PaCO₂. Each 1 kPa increase in CO₂ led to an increase of SjvO₂ by 2.2 %+/-0.66 (p < 0.01) in group I and by 5.7%+/-1.36 (p < 0.0001) in group II. There was no correlation between SjvO₂ and MAP or SjvO₂ and PaO₂.

Conclusion

High mean SjvO₂ are often associated with unfavourable outcomes and high NSE at 48 and 72 hours post-CA. Not only low but also high SjvO₂ values may require therapeutic intervention.

中文翻译：

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心脏骤停后颈静脉血氧饱和度升高

背景

我们对院外心脏骤停 (OHCA) 患者通过颈静脉血氧饱和度 (SjvO ₂ )监测脑氧合的早期研究进行了回顾性分析。该研究的重点是高 SjvO ₂值 (≥ 75%) 及其与神经学结果和血清神经元特异性烯醇化酶 (NSE) 浓度的关联。

方法

将 40 名 OHCA 患者分为（i）高（I 组）、（ii）正常（II 组）和（iii）低（III 组）SjvO ₂，​​平均 SjvO ₂ ≥75%、55-74% 和分别<55%。在心脏骤停后第 90 天（CA 后），使用脑功能分类量表 (CPC) 评估神经系统结果。NSE 浓度在 ICU 入院后测定，然后在 CA 后 24、48 和 72 小时 (h) 测定。

结果

67% 的患者出现高平均 SjvO ₂，​​而没有患者出现低平均 SjvO ₂。第一组的不良结果明显比第二组更常见（74% 对 23%，p < 0.01）。在 CA 后 48 和 72 小时，I 组患者的 NSE 中位数显着高于 II 组。_{SjvO 2}与PaCO ₂呈正相关。_{CO 2}每增加 1 kPa导致第一组 SjvO ₂增加 2.2 %+/-0.66 (p < 0.01)，组 II 增加 5.7%+/-1.36 (p < 0.0001)。_{SjvO 2}与MAP或SjvO ₂与PaO ₂之间没有相关性。

结论

高平均 SjvO ₂通常与不良结果和 CA 后 48 和 72 小时的高 NSE 相关。不仅低而且高的 SjvO ₂值可能需要治疗干预。