Background: Cerebral hypoperfusion may aggravate neurological damage after cardiac arrest. Near-infrared\nspectroscopy (NIRS) provides information on cerebral oxygenation but its relevance during post-resuscitation\ncare is undefined. We investigated whether cerebral oxygen saturation (rSO2) measured with NIRS correlates\nwith the serum concentration of neuron-specific enolase (NSE), a marker of neurological injury, and with clinical\noutcome in out-of-hospital cardiac arrest (OHCA) patients.\nMethods: We performed a post hoc analysis of a randomised clinical trial (COMACARE, NCT02698917) comparing two\ndifferent levels of carbon dioxide, oxygen and arterial pressure after resuscitation from OHCA with ventricular fibrillation\nas the initial rhythm. We measured rSO2 in 118 OHCA patients with NIRS during the first 36 h of intensive care. We\ndetermined the NSE concentrations from serum samples at 48 h after cardiac arrest and assessed neurological outcome\nwith the Cerebral Performance Category (CPC) scale at 6 months. We evaluated the association between rSO2 and serum\nNSE concentrations and the association between rSO2 and good (CPC 1-2) and poor (CPC 3-5) neurological outcome.\nResults: The median (inter-quartile range (IQR)) NSE concentration at 48 h was 17.5 (13.4-25.0) microg/l in patients with good\nneurological outcome and 35.2 (22.6-95.8) microg/l in those with poor outcome, p < 0.001. We found no significant\ncorrelation between median rSO2 and NSE at 48 h, rs = - 0.08, p = 0.392. The median (IQR) rSO2 during the first 36 h of\nintensive care was 70.0% (63.5-77.0%) in patients with good outcome and 71.8% (63.3-74.0%) in patients with poor\noutcome, p = 0.943. There was no significant association between rSO2 over time and neurological outcome. In a binary\nlogistic regression model, rSO2 was not a statistically significant predictor of good neurological outcome (odds ratio 0.99,\n95% confidence interval 0.94-1.04, p = 0.635).\nConclusions: We found no association between cerebral oxygenation measured with NIRS and NSE concentrations or\noutcome in patients resuscitated from OHCA.
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