Prediction of the neurological outcome using regional cerebral oxygen saturation in patients with extracorporeal cardiopulmonary resuscitation after out-of-hospital cardiac arrest: a multicenter retrospective cohort study

Aim: To investigate the association between regional cerebral oxygen saturation (rSO2) and neurological outcomes in extracorporeal cardiopulmonary resuscitation (ECPR) patients after out-of-hospital cardiac arrest (OHCA). Methods: We used data from the Japan-Prediction of Neurological Outcomes in Patients Post-Cardiac Arrest Registry. This registry included consecutive comatose patients after OHCA who were transferred to 15 hospitals in Japan from 2011 to 2013. Our primary end-point was a good neurological outcome (cerebral performance categories 1 or 2) at 90 days after OHCA. Results: Among the enrolled patients, 121 (6.3%) received ECPR. Eleven (9.1%) had a good neurological outcome. Receiver operating characteristic curve analysis revealed the optimal cut-off value as >16%. Good neurological outcomes were observed in 19.6% (9/46) and 2.7% (2/74) of patients with rSO(2) >16% and rSO(2) = 16%, respectively. Conclusion: The neurological outcome of ECPR patients differed according to their rSO(2) values. When considering ECPR, the rSO(2) value could be important in addition to other criteria. Further studies that focus on ECPR patients and serial rSO(2) values are needed.