The prognostic value of using a jugular bulb catheter for measuring oxygen saturation in patients treated with target temperature management 33˚C after cardiac arrest: a prospective study.
(English)Manuscript (preprint) (Other academic)
Objective: To describe variations in jugular bulb oxygen saturation (SjvO2), differences in oxygen content between central venous oxygen saturation (ScvO2) and SjvO2, and oxygen extraction fraction from the brain (OEFb) during intensive care in relation to neurological outcome at 6 months post-cardiac arrest (CA) in cases where target temperature management to 33°C (TTM) was applied.
Design: Prospective observational study.
Setting: One general intensive care unit in a university hospital.
Patients: Patients over 18 years, comatose immediately after resuscitation from CA, regardless of first registered ECG rhythm or whether the CA occurred in or out of hospital.
Measurements and Main Results: One hundred and ten patients were treated with TTM 33°C post-CA and 76 received a single lumen catheter in the right jugular vein. Oxygen saturation from the arterial, jugular bulb and central venous catheter was measured in 75 patients during TTM 33°C and up to 108 hours post-CA. Neurological outcome was assessed using the Cerebral Performance Categories (CPC) and dichotomized into good and poor outcome. Thirty-seven (49%) patients survived with a good outcome (CPC 1-2) at 6 months. Patients with poor outcome showed higher levels of SjvO2 at 6,12, 96 and 108 hours, but this was only significant at 12 (p=0.032), 96 (p=0.018) and 108 hours (p=0.015).Patients with a good outcome showed higher in ScvO2 -SjvO2 values at 6 hours (p=0.001) post-CA. The OEFb was higher in patients with good outcome at 6 (p=0.048), 12 (p=0.015), 96 (p=0.008) and 108 hours (p=0.017).
Conclusions: In the present study, the main differences in the oxygen saturation measures were seen at 6, 12, 96 and 108 hours post-CA. Based on the present findings, we cannot recommend that the values obtained from the jugular bulb catheter post-CA be used to predict outcome, and thus the usefulness of SjvO2 for prognostic purposes is uncertain
cardiac arrest, hypothermia treatment, prognostication, jugular bulb saturation, intensive care, neurological outcome
Anesthesiology and Intensive Care
Research subject Medical Science; Anaesthesiology and Intensive Care
IdentifiersURN: urn:nbn:se:uu:diva-251311OAI: oai:DiVA.org:uu-251311DiVA: diva2:805323