Effectiveness of chest compression using real-time cerebral circulation monitoring in out-of-hospital cardiac arrest patients

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K18351
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55060:Emergency medicine-related
• Research Institution: Kyoto University
• Principal Investigator: KIGUCHI TAKEYUKI 京都大学, 医学研究科, 研究員 (30724380)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 院外心停止 / 心肺蘇生 / 近赤外線分光法 / 病院前救急医療 / 脳循環

Outline of Final Research Achievements

The PILOT Study was started on April 1, 2019 to assess feasibility. But this research was suspended once due to the spread of COVID-19 infection from April 2020. We re-designed study protocol to conduct during a COVID-19 epidemic. And the study was initiated on January 22, 2021 on the NIRO machine only. A total of 256 patients were enrolled, and 75% of the patients had analyzable data. On March 15, 2022, the equipment was ready and the depth of chest compressions could be measured, which was done in 68 cases. The number of cases available for analysis was 46. The correlation between the cerebral blood flow index (O2Hb) measured by NIRO and the average depth of chest compressions was analyzed for the entire section, but no strong correlation was found.

Free Research Field

蘇生科学、救急医学

Academic Significance and Societal Importance of the Research Achievements

本研究の結果にて、現在Gold Standardとなっている胸骨圧迫の質(深さ)とNIROで測定した脳血流指標との関係性を明らかにし、両者においては明らかな相関関係は認めなかった。このことは心停止患者の蘇生中に有効な脳血流を維持するには胸骨圧迫の深さのみでは不十分である可能性がある。脳血流を維持できるような有効な胸骨圧迫を行うためには深さ以外にも胸骨圧迫の位置や患者の体格に応じて深さも変える必要がある。そのためには胸骨圧迫を行う際の指標が必要であり、NIROによる脳循環指標がその一助となる可能性がある。しかし、蘇生中の指標とするためには基準値の設定や課題が残っており、さらなる研究が望まれる。