Non-invasive diffuse optical neuromonitoring during cardiopulmonary resuscitation predicts return of spontaneous circulation

Tiffany S. Ko, Constantine D. Mavroudis, Ryan W. Morgan, Wesley B. Baker, Alexandra M. Marquez, Timothy W. Boorady, Mahima Devarajan, Yuxi Lin, Anna L. Roberts, William P. Landis, Kobina Mensah-Brown, Vinay M. Nadkarni, Robert A. Berg, Robert M. Sutton, Arjun G. Yodh, Daniel J. Licht, Wensheng Guo, Todd J. Kilbaugh

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Neurologic injury is a leading cause of morbidity and mortality following pediatric cardiac arrest. In this study, we assess the feasibility of quantitative, non-invasive, frequency-domain diffuse optical spectroscopy (FD-DOS) neuromonitoring during cardiopulmonary resuscitation (CPR), and its predictive utility for return of spontaneous circulation (ROSC) in an established pediatric swine model of cardiac arrest. Cerebral tissue optical properties, oxy- and deoxy-hemoglobin concentration ([HbO 2], [Hb]), oxygen saturation (StO 2) and total hemoglobin concentration (THC) were measured by a FD-DOS probe placed on the forehead in 1-month-old swine (8-11 kg; n = 52) during seven minutes of asphyxiation followed by twenty minutes of CPR. ROSC prediction and time-dependent performance of prediction throughout early CPR (< 10 min), were assessed by the weighted Youden index (J w, w = 0.1) with tenfold cross-validation. FD-DOS CPR data was successfully acquired in 48/52 animals; 37/48 achieved ROSC. Changes in scattering coefficient (785 nm), [HbO 2], StO 2 and THC from baseline were significantly different in ROSC versus No-ROSC subjects (p < 0.01) after 10 min of CPR. Change in [HbO 2] of + 1.3 µmol/L from 1-min of CPR achieved the highest weighted Youden index (0.96) for ROSC prediction. We demonstrate feasibility of quantitative, non-invasive FD-DOS neuromonitoring, and stable, specific, early ROSC prediction from the third minute of CPR.

Original languageEnglish (US)
Article number3828
JournalScientific reports
Issue number1
StatePublished - Dec 2021
Externally publishedYes

Bibliographical note

Funding Information:
Direct research support was provided by the National Institutes of Health (NIH) F31-HD085731, T32-HL007915 [TSK]; K23-HL148541 [RWM]; TL1-TR001880 [AMM]; R21-HD089132 [RAB, RMS, RWM]; U01-HD063108 [RAB]; R01-NS060653 [AGY, DJL]; P41-EB015893 [AGY, WBB, WG]; R01-NS72338 [DJL]; R01-HL141386 [TJK, RAB, RWM, RMS, DJL]; the Department of Defense (DOD) W81XWH-16-PRMRP-TTDA [TJK]; the Children’s Hospital of Philadelphia (CHOP) Cardiac Center [CDM]; and the June and Steve Wolfson Family Foundation [DJL]. Funding organizations were not involved in the conduct of research nor the preparation of this article.

Publisher Copyright:
© 2021, The Author(s).


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