Acute cardiac care & resuscitation
Cerebral tissue oxygen saturation at defibrillation and return of spontaneous circulation in out-of-hospital cardiac arrest with a shockable rhythm
Authors' conclusion
In this selected population, higher SctO2 at defibrillation was associated with ROSC. This indirect marker and exploratory cutoff need external validation and should not delay guideline-directed defibrillation.
Study context
- Population
- Adult patients with out-of-hospital cardiac arrest who underwent SctO2 monitoring during ongoing CPR and received in-hospital defibrillation for ventricular fibrillation or pulseless ventricular tachycardia
- Comparison
- SctO2 at first monitored defibrillation and return of spontaneous circulation (ROSC) after that defibrillation
- ROSCn = Nineteen
- Outcome
- SctO2 at first monitored defibrillation
Methodological detailslogistic generalized linear mixed-effects model (GLMM) with a patient-level random intercept (secondary), adjusted for site
- Logistic generalized linear mixed-effects model (GLMM) with a patient-level random intercept (secondary)
- Adjusted for site
Main finding
As reported in the abstract
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| ROSC after first monitored defibrillation, per 1% increase in SctO2 | 1.48 (1.22–1.80) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
ROSC across all 194 monitored defibrillations (41 followed by ROSC), adjusted GLMM
| Comparison | OR (95% CI) | P value | |
|---|---|---|---|
| SctO2Association remained consistent | 1.56 (1.34–1.82) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
- ROSC after first monitored defibrillation, per 1% increase in SctO2: adjusted for site, arrest-to-defibrillation time, and epinephrine within 2 min
Discrimination of SctO2 for ROSC
- Area under the receiver operating characteristic curve
- 0.961 (95% CI, 0.917-0.991)
- Sensitivity at SctO2 cut-off of 44.5%
- 94.7% (18/19; 95% CI, 74.0%-99.9%)
- Specificity at SctO2 cut-off of 44.5%
- 89.7% (61/68; 95% CI, 79.9%-95.8%)
Original publication
Cerebral tissue oxygen saturation at defibrillation and return of spontaneous circulation in out-of-hospital cardiac arrest with a shockable rhythm. Resuscitation. Published 31 August 2026. doi:10.
Summarised from the published abstract; every number is checked against it