Lanks, C, Kim, CB and Rossiter, HB orcid.org/0000-0002-7884-0726 (2018) A "NIRS" death experience: a reduction in cortical oxygenation by time-resolved near-infrared spectroscopy preceding cardiac arrest. Journal of Clinical Monitoring and Computing, 32 (4). pp. 683-686. ISSN 1387-1307
Abstract
Near-infrared spectroscopy (NIRS) has been used effectively post-cardiac-arrest to gauge adequacy of resuscitation and predict the likelihood of achieving a return of spontaneous circulation. However, preempting hemodynamic collapse is preferable to achieving ROSC through advanced cardiac life support. Minimizing "time down" without end-organ perfusion has always been a central pillar of ACLS. In many critically ill patients there is a prolonged phase of end-organ hypoperfusion preceding loss of palpable pulses and initiation of ACLS. Due to the relative infrequency of in-hospital cardiac arrest, NIRS has not previously evaluated the period immediately prior to hemodynamic collapse. Here we report a young man who suffered a pulseless electrical activity (PEA) arrest while cortical oxygenation was monitored using time-resolved near-infrared spectroscopy. The onset of cortical deoxygenation preceded the loss of palpable pulses by 15 min, suggesting that TRS-NIRS monitoring might provide a means of preempting PEA arrest. Our experience with this patient represents a promising new direction for continuous NIRS monitoring and has the potential to not only predict clinical outcomes, but affect them to the patient's benefit as well.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) 2017, Springer Science+Business Media B.V. This is an author produced version of a paper published in the Journal of Clinical Monitoring and Computing. Uploaded in accordance with the publisher's self-archiving policy. The final publication is available at Springer via https://doi.org/10.1007/s10877-017-0061-8 |
Keywords: | Near infra-red spectroscopy; NIRS; Cardiac arrest; ACLS; Sepsis; Shock; Septic shock; Cardiopulmonary resuscitation |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Biological Sciences (Leeds) > School of Biomedical Sciences (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 19 Sep 2017 11:59 |
Last Modified: | 08 Sep 2018 00:38 |
Status: | Published |
Publisher: | Springer Verlag |
Identification Number: | 10.1007/s10877-017-0061-8 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:121353 |