Cerebral oxygenation measured by near-infrared spectroscopy during circulatory arrest and cardiopulmonary resuscitation

We measured cerebral oxygenation by near-infrared spectroscopy (NIRS) during an unexpected cardiac arrest and successful cardiopulmonary resuscitation (CPR). A 4-yr-old girl with cyanotic congenital heart disease developed an arrhythmia during cardiac catheterization with subsequent circulatory arrest. Continuous monitoring of cerebral oxygenation showed marked changes in oxygen status immediately after the beginning of the tachyarrhythmia. After 1 min of circulatory arrest, a decrease in oxygenated haemoglobin concentration and cytochrome oxidase signal indicated a critical reduction of oxygen tension. With the beginning of CPR, a rapid increase in cytochrome oxidase oxygenation was observed. Previous values, however, were only restored when sinus rhythm was obtained after successful cardiac defibrillation. Our observations suggest that non-invasive cerebral MRS measurement gives useful additional realtime information on cerebral oxygenation during cardiac arrest and CPR.