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Sep 13, 2018

ERC congress - Resuscitation 2018

4 - Usefulness of Bispectral index during Cardiopulmonary Resuscitation: An experimental study.

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Bispectral index

cardiopulmonary resuscitation

rosc

Abstract

Abstract

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Keywords

Bispectral index

cardiopulmonary resuscitation

rosc

Abstract

Autors: Fontanals J1, Caballero A1, Bobi J2, Magaldi M1, Chanza M1, Fabregas N1. 1.Department of Anaesthesia and Intensive Care, Hospital Clinic de Barcelona, Spain. 2.Deparment of Cardiology IDIBAPS. Hospital Clinic de Barcelona. Spain Purpose of study: Currently, there are no objective monitoring methods available to gauge the effectiveness of advanced life support for cerebral resuscitation. We assessed the usefulness of bispectral index system monitoring (BIS) as a marker for cerebral protection during cardiopulmonary resuscitation (CPR). Methods: Twenty three Landrace x Large-White pigs underwent cardiac arrest (CA) by ventricular fibrillation, advance life support was initiated after 5 minutes of CA with mechanical chest compressions (LUCAS) and mechanical ventilation. ECG, mean invasive arterial pressure (MAP), cardiac output by Swan-Ganz catheter, BIS and end tidal CO2 (ETCO2) were measured before CA and every two minutes during resuscitation until 30 minutes post-CA. Data was analysed with SPSS statistical software v24. Sensitivity, specificity and area under the ROC curve were calculated. Results: Twenty animals (87%) presented returned of spontaneous circulation (ROSC). A BIS value < 30 was maintained, between 14 and 30 minutes, in animals who did not achieve ROSC, with high sensitivity and specificity rates. Animals which did not present ROSC maintained MAP < 40 mmHg from 16 minute post-CA, and ETCO2 < 15 mmHg from 18 minute post-CA. A potential correlation (r2 > 0.7) exists between the values of BIS, MAP and ETCO2. Conclusions: BIS monitoring values < 30 have the potential to show correlation with low values of MAP, ETCO2 and could suggest the importance of BIS as a marker of survival during CPR. Further studies are needed to support these results.

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All rights reserved.