Are changes in cerebrovascular autoregulation following cardiac arrest associated with neurological outcome? Results of a pilot study

Resuscitation
Paul PhamAnders Aneman

Abstract

To investigate the association between impaired cerebrovascular autoregulation (CVAR) and outcome in comatose survivors of cardiac arrest. The correlation in the time domain between cerebral tissue oxygenation (cStO2) using near infrared spectroscopy (NIRS) and mean arterial pressure was used to determine the tissue oxygenation index (TOx) as a reflection of normal (TOx<0) or impaired (TOx>0) CVAR. Daily measurements (>1h recording time) were performed in the first three days post cardiac arrest. Survival and neurological outcome was assessed at three months following cardiac arrest. A control group of healthy volunteers was also investigated. 23 patients and 28 volunteers were studied. All survivors (n=8) of cardiac arrest had a good neurological outcome. The TOx (median [interquartile range] for days 1-3) was higher (Mann Whitney test, p<0.001) in non-survivors (0.04 [-0.02 to -0.16]) compared to survivors (-0.11 [-0.19 to -0.02]) and healthy volunteers (-0.15 [-0.27 to -0.04]) on every day and for days 1-3 following cardiac arrest. The TOx was not significantly different between survivors and healthy volunteers. The cStO2 did not discriminate survivors (67 [62-72]%) from non-survivors (71 [65-75]%). Logistic regression analy...Continue Reading

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