Cerebral oximetry and return of spontaneous circulation after XXXX : A systematic review and meta-analysis.

@entity1 @entity26 @entity580 @entity1167
AIM: The prediction of return of spontaneous circulation (ROSC) during resuscitation of @entity1 suffering of @entity1167 (CA) is particularly challenging. Regional cerebral @entity26 saturation (rSO2) monitoring through near-infrared spectrometry is feasible during CA and could provide guidance during resuscitation. METHODS: We conducted a systematic review and meta-analysis on the value of rSO2 in predicting ROSC both after @entity580 ( @entity580 ) or out-of-hospital (OH) CA. Our search included MEDLINE (PubMed) and EMBASE, from inception until April 4th, 2015. We included studies reporting values of rSO2 at the beginning of and/or during resuscitation, according to the achievement of ROSC. RESULTS: A total of nine studies with 315 @entity1 (119 achieving ROSC, 37.7%) were included in the meta-analysis. The majority of those @entity1 had an OHCA (n=225, 71.5%; IHCA: n=90, 28.5%). There was a significant association between higher values of rSO2 and ROSC, both in the overall calculation (standardized mean difference, SMD -1.03; 95%CI -1.39,-0.67; p<0.001), and in the subgroups analyses (rSO2 at the beginning of resuscitation: SMD -0.79; 95%CI -1.29,-0.30; p=0.002; averaged rSO2 value during resuscitation: SMD -1.28; 95%CI -1.74,-0.83; p<0.001). CONCLUSIONS: Higher initial and average regional cerebral @entity26 saturation values are both associated with greater chances of achieving ROSC in @entity1 suffering of CA. A note of caution should be made in interpreting these results due to the small number of @entity1 and the heterogeneity in study design: larger studies are needed to clinically validate cut-offs for guiding cardiopulmonary resuscitation.
