Cerebral oxygen desaturation events during and functional outcomes after prehospital anaesthesia: A prospective pilot study

Jouni Nurmi, Päivi Laukkanen-Nevala, Hetti Kirves, Lasse Raatiniemi, Tuukka Toivonen, Miretta Tommila, Heini Piiroinen, Piritta Setälä, Pamela Karhivuori, Simo Tukia, Anna Olkinuora

    Research output: Contribution to journalArticleScientificpeer-review

    1 Citation (Scopus)
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    Abstract

    Background: During prehospital anaesthesia, oxygen delivery to the brain might be inadequate to match the oxygen consumption, with unknown long-term functional outcomes. We aimed to evaluate the feasibility of monitoring cerebral oxygenation during prehospital anaesthesia and determining the long-term outcomes. Methods: We performed a prospective observational feasibility study in two helicopter emergency medical services units. Frontal lobe regional oxygen saturation (rSO2) of adult patients undergoing prehospital anaesthesia was monitored with near-infrared spectroscopy (NIRS) by a Nonin H500 oximeter. The outcome was evaluated with a modified Rankin Scale (mRS) at 30 days and 1 year. Health-related quality of life (HRQoL) was measured with a 15D instrument at 1 year. Results: Of 101 patients enrolled, 83 were included. The mean baseline rSO2 was 79% (73–84). Desaturation for at least 5 min to rSO2 below 50% or a decrease of 10% from baseline occurred in four (5%, 95% CI 2%–12%) and 19 (23%, 95% CI 15–93) patients. At 1 year, 32 patients (53%, 95% CI 41–65) achieved favourable neurological outcomes. The median 15D score was 0.889 (Q1–Q3, 0.796–0.970). Conclusion: Monitoring cerebral oxygenation with a hand-held oximeter during prehospital anaesthesia and collecting data on functional outcomes and HRQoL are feasible. Only half of the patients achieved a favourable functional outcome. The effects of cerebral oxygenation on outcomes during prehospital critical care need to be assessed in future studies.

    Original languageEnglish
    Pages (from-to)750-758
    Number of pages9
    JournalACTA ANAESTHESIOLOGICA SCANDINAVICA
    Volume66
    Issue number6
    DOIs
    Publication statusPublished - 2022
    Publication typeA1 Journal article-refereed

    Keywords

    • cerebral oxygenation
    • helicopter emergency
    • medical services
    • near-infrared spectroscopy
    • prehospital anaesthesia

    Publication forum classification

    • Publication forum level 1

    ASJC Scopus subject areas

    • Anesthesiology and Pain Medicine

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