Dataset from:    Post resuscitation oxygen therapy in out-of-hospital cardiac arrest. Pulse oxymeter versus pulse oximeter associated with oxygen reserve index measurement guided care: a randomized controlled trial.

   

This prospective study aimed to assess the impact of pre-hospital oxygenation on outcomes in patients who experienced out-of-hospital cardiac arrest (OHCA). The study followed a parallel, randomised, single-blind design with an equal number of participants in each group. The research was conducted by rapid response car (RRC) teams from two hospitals in Brussels, Belgium, covering a significant area.

Adult patients who achieved return of spontaneous circulation (ROSC) after an OHCA lasting over 5 minutes were enrolled based on specific criteria. Non-invasive monitoring tools such as pulse oximetry, continuous ECG, non-invasive arterial pressure, and, in most cases, non-invasive end-tidal CO2 monitoring, were used. Exclusions included traumatic cardiac arrest, patients under 18 years, pregnant individuals, prisoners, and those with study device malfunctions.

Patients were randomly assigned to either the control or treatment group immediately after ROSC using sealed envelopes. Monitoring involved pulse oximeters and an additional device called Radical 7, which continuously measured Oxygen Reserve Index (ORI) using Masimo Rainbow SET® Pulse CO-Oximetry.

In the control group, ORI monitoring was turned off during the intervention. The fraction of inspired oxygen (FiO2) was adjusted according to a study protocol to maintain a target arterial oxygen saturation (SatO2) of 94% to 98%. On the other hand, the treatment group had access to ORI values, which guided FiO2 adjustments alongside SatO2 to achieve the same target range.

All patients received pre-hospital ventilation using the Monnal T60 ventilator, allowing adjustments of FiO2 between 0.21 and 1. Post-resuscitation treatment followed the 2015 European Resuscitation Council guidelines.

Data collection involved continuous waveform data storage from SatO2 and ORI using the Radical 7 monitor. Arrest data, demographic information, and blood gas analyses were obtained from patient records and the Belgian cardiac arrest registry. Patients who survived for two days underwent a neuron-specific enolase (NSE) analysis at 48 hours post-ROSC.

The primary endpoint of the study was the normoxia index, a measure that reflected the proportion and intensity of time spent without hyperoxia or hypoxia during the pre-hospital intervention. Secondary outcomes included arterial blood gas analysis (PaO2) at hospital admission and neuron-specific enolase levels at 48 hours post-ROSC.

This study aimed to provide valuable insights into the effects of pre-hospital oxygenation on outcomes in OHCA patients, with the normoxia index serving as a key indicator of oxygen exposure during the intervention.