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CPR'da ROSC Teşhisi İçin Bispektral İndeks'in Rolünün Araştırılması: Daha Fazla Araştırma İçin Bir Çağrı

Yıl 2023, , 107 - 109, 27.12.2023
https://doi.org/10.55994/ejcc.1397181

Öz

Güncel kardiyopulmoner resüsitasyon (KPR) yaklaşımı, göğüs kompresyonlarını durdurarak nabzı değerlendirmeyi ve Spontan Dolaşımın Geri Dönüşünü (ROSC) teşhis etmeyi içerir. Bu kritik adım, resüsitasyon çabalarının etkinliğini belirlemek için hayati öneme sahiptir. Ancak, KPR'nin durdurulması, araştırmacıları ROSC'yi teşhis etmenin, devam eden resüsitasyon sürecini tehlikeye atmadan alternatif yöntemlerini keşfetmeye yönlendiren bir zorluk ortaya çıkarır.
Literatürde önerilen potansiyel bir çözüm, Bispektral İndeks'in (BIS) kullanımıdır. BIS, işlenmiş elektroensefalografi verilerinden türetilen sayısal bir değerdir ve anestezi veya sedasyon derinliğini ölçer. Bazı çalışmalar, KPR sırasında başarılı ROSC'yi takiben BIS değerlerinde bir artış bildirmiştir. Bu gözlem, BIS seviyelerinin izlenmesinin serebral perfüzyon ve nörolojik durum hakkında gerçek zamanlı bilgi sağlayabileceğini, KPR durdurmayı gerektiren nabzın kontrolü ihtiyacını ortadan kaldırabileceğini öne sürmektedir.
Bu umut verici göstergelere rağmen, konuyla ilgili sınırlı mevcut literatürü kabul etmek önemlidir. KPR sırasında ROSC'yi teşhis etmek için BIS kullanımını destekleyen kanıtlar henüz sağlam değildir ve daha fazla araştırmaya ihtiyaç vardır. Araştırmacılar, bu keşfedilmemiş alana derinlemesine incelemeler yaparak, BIS'in resüsitasyon çabaları sırasında sürekli izleme için bir araç olarak güvenilirliğini ve etkinliğini değerlendirmelidir.
Sonuç olarak, KPR sırasında ROSC'yi teşhis etmek için BIS kullanma konsepti potansiyel taşısa da, bu, önemli araştırma ilgisi gerektiren bir alan olarak kalır. Sınırlı mevcut literatür, BIS'in KPR protokolüne entegre edilmesinin olanaklarını ve güvenilirliğini belirlemek için daha kapsamlı araştırmalara olan ihtiyacı vurgular. Teknoloji ilerledikçe, resüsitasyon sırasında sürekli değerlendirme için yenilikçi yaklaşımları keşfetmek, kardiyak arrest senaryolarında sonuçları iyileştirmek için kaçınılmaz hale gelir.

Kaynakça

  • 1. Fletcher DJ, Boller M. Fluid Therapy During Cardiopulmonary Resuscitation. Front Vet Sci. 2021 Jan 28;7:625361. doi: 10.3389/fvets.2020.625361.
  • 2. Garg R, Ahmed SM, Kapoor MC, Rao SC, Mishra BB, Kalandoor MV, et al. Comprehensive cardiopulmonary life support (CCLS) for cardiopulmonary resuscitation by trained paramedics and medics inside the hospital. Indian J Anaesth. 2017 Nov;61(11):883-894. doi: 10.4103/ija.IJA_664_17.
  • 3. Mitropoulou P, Fitzsimmons S. Cardiopulmonary resuscitation. Medicine (Abingdon). 2022 Sep;50(9):599-606. doi: 10.1016/j.mpmed.2022.06.007.
  • 4. Sönmez E, Gülen B. Ultrasound is useful in cardiac arrest, but we still have concerns. Resuscitation. 2020 Jan 1;146:147-148. doi: 10.1016/j.resuscitation.2019.09.039. Epub 2019 Nov 30. PMID: 31794785.
  • 5. Yılmaz C, Gülen B, Sönmez E, Akbay D, Söğüt Ö, Özdemir S, et al. Serum SCUBE-1 Levels and Return of Spontaneous Circulation Following Cardiopulmonary Resuscitation in Adult Patients. Avicenna J Med. 2022 Sep 5;12(3):148-153. doi: 10.1055/s-0042-1755389.
  • 6. Yagi T, Nagao K, Kawamorita T, Soga T, Ishii M, Chiba N, et al. Detection of ROSC in Patients with Cardiac Arrest During Chest Compression Using NIRS: A Pilot Study. Adv Exp Med Biol. 2016;876:151-157. doi: 10.1007/978-1-4939-3023-4_19.
  • 7. Kodali BS, Urman RD. Capnography during cardiopulmonary resuscitation: Current evidence and future directions. J Emerg Trauma Shock. 2014 Oct;7(4):332-40. doi: 10.4103/0974-2700.142778. PMID: 25400399; PMCID: PMC4231274.
  • 8. İslam MM, Aksel G, Eroğlu SE, Yönak H. Diagnostic Accuracy of the Carbon Dioxide Gap (ΔCO2) in Predicting the Return of Spontaneous Circulation: A Prospective Single Center Study. Batı Karadeniz Tıp Dergisi. 2023; 7(2): 211-218.
  • 9. An HR, Han YR, Wang TH, Chi F, Meng Y, Zhang CY, et al. Meta-Analysis of the Factors Influencing the Restoration of Spontaneous Circulation After Cardiopulmonary Resuscitation. Front Physiol. 2022 Mar 8;13:834352. doi: 10.3389/fphys.2022.834352.
  • 10. Jackie Lam JK, Pek JH. Post-resuscitation care of patients with return of spontaneous circulation after out-of-hospital cardiac arrest at the emergency department. Singapore Med J. 2023 Apr 27. doi: 10.4103/singaporemedj.SMJ-2021-354.
  • 11. Özdemir S, Cimilli T, Onur ÖE. Relationship between the National Institutes Health Stroke Scale Score and Bispectral Index in Patients with Acute Ischemic Stroke. J Exp Clin Med. 2021; 38(4): 440-444. doi:10.52142/omujecm.38.4.7.
  • 12. Kusken O, Ozturk TC, Hunuk A, Akoglu EU, Ak R, Turan CA, et al. Relationship between brain computed tomography findings and bispectral index score in patients presenting with head trauma. North Clin Istanb. 2019 Aug 25;6(3):219-225. doi: 10.14744/nci.2018.89266.
  • 13. Sönmez E, Özkan A. Bispectral İndex. J Exp Clin Med. 2022; 39(2): 587-588. doi: 10.52142/omujecm.39.2.60.
  • 14. Punjasawadwong Y, Phongchiewboon A, Bunchungmongkol N. Bispectral index for improving anaesthetic delivery and postoperative recovery. Cochrane Database Syst Rev. 2014 Jun 17;2014(6):CD003843. doi: 10.1002/14651858.CD003843.pub3.
  • 15. Azim N, Wang CY. The use of bispectral index during a cardiopulmonary arrest: a potential predictor of cerebral perfusion. Anaesthesia. 2004 Jun;59(6):610-2. doi: 10.1111/j.1365-2044.2004.03736.x. PMID: 15144304.
  • 16. Özdemir S, Öcal O, Demir H, Metiner Y, Cimilli T, Hünük A, et al. Post arrest bispectral index monitoring. Journal of Experimental and Clinical Medicine. 2023; 40(1): 186-187. doi: 10.52142/omujecm.40.1.35.
  • 17. Chakravarthy M, Patil T, Jayaprakash K, Shivananda N, Jawali V. Bispectral index is an indicator of adequate cerebral perfusion during cardiopulmonary resuscitation. J Cardiothorac Vasc Anesth. 2003 Aug;17(4):506-8. doi: 10.1016/s1053-0770(03)00160-5.
  • 18. Nitzschke R, Schmidt GN. Electroencephalography during out-of-hospital cardiopulmonary resuscitation. J Emerg Med. 2012 Oct;43(4):659-62. doi: 10.1016/j.jemermed.2010.05.098.
  • 19. Shibata S, Imota T, Shigeomi S, Sato W, Enzan K. Use of the bispectral index during the early postresuscitative phase after out-of-hospital cardiac arrest. J Anesth. 2005;19(3):243-6. doi: 10.1007/s00540-005-0317-1.
  • 20. Liu H, Liu Y, Xu Y, Xue Y. Prognostic evaluation of bispectral index in patients following cardiopulmonary resuscitation. Exp Ther Med. 2013 Mar;5(3):907-911. doi: 10.3892/etm.2013.884.
  • 21. Çetinkaya Ünal G. Kardiyak Arrest Hastalarda Bispektral İndeks Skorunun Spontan Dolaşima Dönüşü ve Nörolojik Sağ Kalimi İle İlişkisi. (Thesis in Medicine). İzmir. Sağlık Bilimleri Üniversitesi.

Exploring the Role of Bispectral Index in Interrupting CPR for ROSC Diagnosis: A Call for Further Research

Yıl 2023, , 107 - 109, 27.12.2023
https://doi.org/10.55994/ejcc.1397181

Öz

The current approach in cardiopulmonary resuscitation (CPR) involves interrupting the chest compressions to assess the pulse and diagnose Return of Spontaneous Circulation (ROSC). This critical step is essential for determining the effectiveness of resuscitation efforts. However, the interruption of CPR poses a challenge, prompting researchers to explore alternative methods for diagnosing ROSC without compromising the ongoing resuscitation process.
One potential solution proposed in the literature is the use of the Bispectral Index (BIS). BIS is a numerical value derived from processed electroencephalogram data, providing a measure of the depth of anesthesia or sedation. Some studies have reported an increase in BIS values following successful ROSC during CPR. This observation suggests that monitoring BIS levels could offer real-time information about cerebral perfusion and neurological status, eliminating the need for pulse checks that require CPR interruption.
Despite these promising indications, it is crucial to acknowledge the limited existing literature on the subject. The evidence supporting the use of BIS in diagnosing ROSC during CPR is not yet robust, and further research is warranted. Researchers are encouraged to delve into this unexplored area, conducting comprehensive studies to assess the reliability and effectiveness of BIS as a tool for continuous monitoring during resuscitation efforts.
In conclusion, while the concept of using BIS to diagnose ROSC during CPR holds potential, it remains an area that requires substantial research attention. The limited existing literature underscores the need for more extensive investigations to determine the feasibility and reliability of integrating BIS into the CPR protocol. As technology advances, exploring innovative approaches for continuous assessment during resuscitation becomes imperative for improving outcomes in cardiac arrest scenarios

Kaynakça

  • 1. Fletcher DJ, Boller M. Fluid Therapy During Cardiopulmonary Resuscitation. Front Vet Sci. 2021 Jan 28;7:625361. doi: 10.3389/fvets.2020.625361.
  • 2. Garg R, Ahmed SM, Kapoor MC, Rao SC, Mishra BB, Kalandoor MV, et al. Comprehensive cardiopulmonary life support (CCLS) for cardiopulmonary resuscitation by trained paramedics and medics inside the hospital. Indian J Anaesth. 2017 Nov;61(11):883-894. doi: 10.4103/ija.IJA_664_17.
  • 3. Mitropoulou P, Fitzsimmons S. Cardiopulmonary resuscitation. Medicine (Abingdon). 2022 Sep;50(9):599-606. doi: 10.1016/j.mpmed.2022.06.007.
  • 4. Sönmez E, Gülen B. Ultrasound is useful in cardiac arrest, but we still have concerns. Resuscitation. 2020 Jan 1;146:147-148. doi: 10.1016/j.resuscitation.2019.09.039. Epub 2019 Nov 30. PMID: 31794785.
  • 5. Yılmaz C, Gülen B, Sönmez E, Akbay D, Söğüt Ö, Özdemir S, et al. Serum SCUBE-1 Levels and Return of Spontaneous Circulation Following Cardiopulmonary Resuscitation in Adult Patients. Avicenna J Med. 2022 Sep 5;12(3):148-153. doi: 10.1055/s-0042-1755389.
  • 6. Yagi T, Nagao K, Kawamorita T, Soga T, Ishii M, Chiba N, et al. Detection of ROSC in Patients with Cardiac Arrest During Chest Compression Using NIRS: A Pilot Study. Adv Exp Med Biol. 2016;876:151-157. doi: 10.1007/978-1-4939-3023-4_19.
  • 7. Kodali BS, Urman RD. Capnography during cardiopulmonary resuscitation: Current evidence and future directions. J Emerg Trauma Shock. 2014 Oct;7(4):332-40. doi: 10.4103/0974-2700.142778. PMID: 25400399; PMCID: PMC4231274.
  • 8. İslam MM, Aksel G, Eroğlu SE, Yönak H. Diagnostic Accuracy of the Carbon Dioxide Gap (ΔCO2) in Predicting the Return of Spontaneous Circulation: A Prospective Single Center Study. Batı Karadeniz Tıp Dergisi. 2023; 7(2): 211-218.
  • 9. An HR, Han YR, Wang TH, Chi F, Meng Y, Zhang CY, et al. Meta-Analysis of the Factors Influencing the Restoration of Spontaneous Circulation After Cardiopulmonary Resuscitation. Front Physiol. 2022 Mar 8;13:834352. doi: 10.3389/fphys.2022.834352.
  • 10. Jackie Lam JK, Pek JH. Post-resuscitation care of patients with return of spontaneous circulation after out-of-hospital cardiac arrest at the emergency department. Singapore Med J. 2023 Apr 27. doi: 10.4103/singaporemedj.SMJ-2021-354.
  • 11. Özdemir S, Cimilli T, Onur ÖE. Relationship between the National Institutes Health Stroke Scale Score and Bispectral Index in Patients with Acute Ischemic Stroke. J Exp Clin Med. 2021; 38(4): 440-444. doi:10.52142/omujecm.38.4.7.
  • 12. Kusken O, Ozturk TC, Hunuk A, Akoglu EU, Ak R, Turan CA, et al. Relationship between brain computed tomography findings and bispectral index score in patients presenting with head trauma. North Clin Istanb. 2019 Aug 25;6(3):219-225. doi: 10.14744/nci.2018.89266.
  • 13. Sönmez E, Özkan A. Bispectral İndex. J Exp Clin Med. 2022; 39(2): 587-588. doi: 10.52142/omujecm.39.2.60.
  • 14. Punjasawadwong Y, Phongchiewboon A, Bunchungmongkol N. Bispectral index for improving anaesthetic delivery and postoperative recovery. Cochrane Database Syst Rev. 2014 Jun 17;2014(6):CD003843. doi: 10.1002/14651858.CD003843.pub3.
  • 15. Azim N, Wang CY. The use of bispectral index during a cardiopulmonary arrest: a potential predictor of cerebral perfusion. Anaesthesia. 2004 Jun;59(6):610-2. doi: 10.1111/j.1365-2044.2004.03736.x. PMID: 15144304.
  • 16. Özdemir S, Öcal O, Demir H, Metiner Y, Cimilli T, Hünük A, et al. Post arrest bispectral index monitoring. Journal of Experimental and Clinical Medicine. 2023; 40(1): 186-187. doi: 10.52142/omujecm.40.1.35.
  • 17. Chakravarthy M, Patil T, Jayaprakash K, Shivananda N, Jawali V. Bispectral index is an indicator of adequate cerebral perfusion during cardiopulmonary resuscitation. J Cardiothorac Vasc Anesth. 2003 Aug;17(4):506-8. doi: 10.1016/s1053-0770(03)00160-5.
  • 18. Nitzschke R, Schmidt GN. Electroencephalography during out-of-hospital cardiopulmonary resuscitation. J Emerg Med. 2012 Oct;43(4):659-62. doi: 10.1016/j.jemermed.2010.05.098.
  • 19. Shibata S, Imota T, Shigeomi S, Sato W, Enzan K. Use of the bispectral index during the early postresuscitative phase after out-of-hospital cardiac arrest. J Anesth. 2005;19(3):243-6. doi: 10.1007/s00540-005-0317-1.
  • 20. Liu H, Liu Y, Xu Y, Xue Y. Prognostic evaluation of bispectral index in patients following cardiopulmonary resuscitation. Exp Ther Med. 2013 Mar;5(3):907-911. doi: 10.3892/etm.2013.884.
  • 21. Çetinkaya Ünal G. Kardiyak Arrest Hastalarda Bispektral İndeks Skorunun Spontan Dolaşima Dönüşü ve Nörolojik Sağ Kalimi İle İlişkisi. (Thesis in Medicine). İzmir. Sağlık Bilimleri Üniversitesi.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Acil Tıp
Bölüm Review Article
Yazarlar

Serdar Özdemir 0000-0002-6186-6110

Yayımlanma Tarihi 27 Aralık 2023
Gönderilme Tarihi 28 Kasım 2023
Kabul Tarihi 7 Aralık 2023
Yayımlandığı Sayı Yıl 2023

Kaynak Göster

APA Özdemir, S. (2023). Exploring the Role of Bispectral Index in Interrupting CPR for ROSC Diagnosis: A Call for Further Research. Eurasian Journal of Critical Care, 5(3), 107-109. https://doi.org/10.55994/ejcc.1397181
AMA Özdemir S. Exploring the Role of Bispectral Index in Interrupting CPR for ROSC Diagnosis: A Call for Further Research. Eurasian j Crit Care. Aralık 2023;5(3):107-109. doi:10.55994/ejcc.1397181
Chicago Özdemir, Serdar. “Exploring the Role of Bispectral Index in Interrupting CPR for ROSC Diagnosis: A Call for Further Research”. Eurasian Journal of Critical Care 5, sy. 3 (Aralık 2023): 107-9. https://doi.org/10.55994/ejcc.1397181.
EndNote Özdemir S (01 Aralık 2023) Exploring the Role of Bispectral Index in Interrupting CPR for ROSC Diagnosis: A Call for Further Research. Eurasian Journal of Critical Care 5 3 107–109.
IEEE S. Özdemir, “Exploring the Role of Bispectral Index in Interrupting CPR for ROSC Diagnosis: A Call for Further Research”, Eurasian j Crit Care, c. 5, sy. 3, ss. 107–109, 2023, doi: 10.55994/ejcc.1397181.
ISNAD Özdemir, Serdar. “Exploring the Role of Bispectral Index in Interrupting CPR for ROSC Diagnosis: A Call for Further Research”. Eurasian Journal of Critical Care 5/3 (Aralık 2023), 107-109. https://doi.org/10.55994/ejcc.1397181.
JAMA Özdemir S. Exploring the Role of Bispectral Index in Interrupting CPR for ROSC Diagnosis: A Call for Further Research. Eurasian j Crit Care. 2023;5:107–109.
MLA Özdemir, Serdar. “Exploring the Role of Bispectral Index in Interrupting CPR for ROSC Diagnosis: A Call for Further Research”. Eurasian Journal of Critical Care, c. 5, sy. 3, 2023, ss. 107-9, doi:10.55994/ejcc.1397181.
Vancouver Özdemir S. Exploring the Role of Bispectral Index in Interrupting CPR for ROSC Diagnosis: A Call for Further Research. Eurasian j Crit Care. 2023;5(3):107-9.

Indexing and Abstracting

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