Key result
Post-arrest CBF uncouples from MAP and predicts EEG resumption after 5-minute but not 7-minute arrest.
Why the study?
The physiological relationship between cerebral blood flow, blood pressure, and brain electrical activity after resuscitation from cardiac arrest is not fully understood.
Following cardiac arrest, cerebral blood flow and blood pressure become uncoupled after stabilized hypoperfusion, with EEG activity resuming prior to this uncoupling.
Facilitates precise quantification of post-resuscitation cerebral hyperemia and hypoperfusion in experimental models; leaves open clinical translation pending validation.
In the present study, we have developed a multi-modal instrument that combines laser speckle imaging, arterial blood pressure, and electroencephalography (EEG) to quantitatively assess cerebral blood flow (CBF), mean arterial pressure (MAP), and brain electrophysiology before, during, and after asphyxial cardiac arrest (CA) and resuscitation. Using the acquired data, we quantified the time and magnitude of the CBF hyperemic peak and stabilized hypoperfusion after resuscitation. Furthermore, we assessed the correlation between CBF and MAP before and after stabilized hypoperfusion. Finally, we examined when brain electrical activity resumes after resuscitation from CA with relation to CBF and MAP, and developed an empirical predictive model to predict when brain electrical activity resumes after resuscitation from CA. Our results show that: 1) more severe CA results in longer time to stabilized cerebral hypoperfusion; 2) CBF and MAP are coupled before stabilized hypoperfusion and uncoupled after stabilized hypoperfusion; 3) EEG activity (bursting) resumes after the CBF hyperemic phase and before stabilized hypoperfusion; 4) CBF predicts when EEG activity resumes for 5-min asphyxial CA, but is a poor predictor for 7-min asphyxial CA. Together, these novel findings highlight the importance of using multi-modal approaches to investigate CA recovery to better understand physiological processes and ultimately improve neurological outcome.
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Crouzet et al. (2016) studied Asphyxial cardiac arrest. Asphyxial cardiac arrest was evaluated on Time to stabilized cerebral hypoperfusion and resumption of EEG activity. Following asphyxial cardiac arrest, cerebral blood flow and mean arterial pressure become uncoupled after stabilized hypoperfusion, and CBF predicts EEG resumption for 5-min but not 7-min arrest.
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