Development of physiological monitoring method by NIRS to evaluate appropriate chest compression at cardiac arrest

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K09400
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55060:Emergency medicine-related
• Research Institution: Kagoshima University
• Principal Investigator: Kakihana Yasuyuki 鹿児島大学, 医歯学域医学系, 教授 (20264426)
• Co-Investigator(Kenkyū-buntansha): 伊藤 隆史 鹿児島大学, 医歯学総合研究科, 特任准教授 (20381171) ; 上國料 千夏 鹿児島大学, 医歯学総合研究科, 特任助教 (50751278)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: 心肺蘇生法 / 胸骨圧迫 / 自己心拍再開 / 近赤外線分光法 / NIRO装置 / パルス波形 / 脳内酸素飽和度

Outline of Final Research Achievements

In recent years, it has been pointed out that cerebral oxygen saturation may be an indicator of resuscitation. Therefore, we conducted this study on the assumption that during resuscitation, "cerebral oxygen saturation is an indicator of (1) antegrade cerebral blood flow, and (2) return of spontaneous circulation (ROSC)." Retrograde cerebral blood flow during resuscitation was not confirmed, although contrast medium was injected into the right atrium. On the other hand, it was found that the difference in the site of chest compression greatly affects the resuscitation effect, and the time phase changes of oxygenated and deoxygenated Hb in the NIRO device pulse waveform were shown to be useful for evaluating antegrade/retrograde cerebral blood flow during chest compression. In addition, although it was not possible to obtain the absolute value of cerebral oxygen saturation as an indicator of ROSC, the pulse waveform and cerebral oxygen saturation were useful for evaluating ROSC.

Free Research Field

救急領域、集中治療領域、麻酔科領域

Academic Significance and Societal Importance of the Research Achievements

今回の研究から、胸骨圧迫部位の違いが蘇生効果に大きく影響することが判明し、NIRO装置パルス波形の酸素化型Hbと脱酸素化型Hbの時相変化は、胸骨圧迫時の順行性/逆行性脳血流の評価にも有用であることが示された。また、蘇生時の胸骨圧迫法が適切かつ有効に実施されているのかをNIRO装置パルス波形で連続的に評価できることから、ROSCの評価にも有用であることが示された。この研究成果は、これまで10%以下であった心原性心停止症例の社会復帰率向上につながることが期待される。