CT Brain Perfusion Patterns and Clinical Outcome after Successful Cardiopulmonary Resuscitation: A Pilot Study.

Hakim, Arsany; Branca, Mattia; Kurmann, Christoph; Wagner, Benedikt; Iten, Manuela; Hänggi, Matthias; Wagner, Franca (2024). CT Brain Perfusion Patterns and Clinical Outcome after Successful Cardiopulmonary Resuscitation: A Pilot Study. Resuscitation, 200(110216), p. 110216. Elsevier 10.1016/j.resuscitation.2024.110216

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AIM

CT perfusion is a valuable tool for evaluating cerebrovascular diseases, but its role in patients with hypoxic ischaemic encephalopathy is unclear. This study aimed to investigate 1) the patterns of cerebral perfusion changes that may occur early on after successful resuscitation, and 2) their correlation with clinical outcome to explore their value for predicting outcome.

METHODS

We conducted a retrospective analysis of perfusion maps from patients who underwent CT brain perfusion within 12 hours following successful resuscitation. We classified the perfusion changes into distinct patterns. According to the cerebral performance category (CPC) score clinical outcome was categorised as favourable (CPC 1-2), or unfavourable (CPC 3-5).

RESULTS

A total of 87 patients were included of whom 33 had a favourable outcome (60.6% male, mean age 60 ±16 years), whereas 54 exhibited an unfavourable outcome (59.3% male, mean age 60 ±19 years). Of the patients in the favourable outcome group, 30.3% showed no characteristic perfusion changes, in contrast to the unfavourable outcome group where all patients exhibit changes in perfusion. Eighteen perfusion patterns were identified. The most significant patterns for prediction of unfavourable outcome in terms of their high specificity and frequency were hypoperfusion of the brainstem as well as coexisting hypoperfusion of the brainstem and thalamus.

CONCLUSION

This pilot study identified various perfusion patterns in patients after resuscitation, indicative of circulatory changes associated with post-cardiac-arrest brain injury. After validation, certain patterns could potentially be used in conjunction with other prognostic markers for stratifying patients and adjusting personalized treatment following cardiopulmonary resuscitation. Normal brain perfusion within 12 hours after resuscitation is predictive of favourable outcome with high specificity.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
04 Faculty of Medicine > Pre-clinic Human Medicine > Department of Clinical Research (DCR)
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Hakim, Arsany, Branca, Mattia, Kurmann, Christoph Carmelino, Wagner, Benedikt, Iten, Manuela, Hänggi, Matthias, Wagner, Franca

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1873-1570

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

17 Apr 2024 10:22

Last Modified:

19 Jun 2024 00:15

Publisher DOI:

10.1016/j.resuscitation.2024.110216

PubMed ID:

38626861

Uncontrolled Keywords:

CT perfusion brain cardiopulmonary resuscitation, post-cardiac-arrest brain injury hypoxic brain injury prognosis

BORIS DOI:

10.48350/196024

URI:

https://boris.unibe.ch/id/eprint/196024

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