Diffusion and perfusion MRI of the brain in comatose patients treated with mild hypothermia after cardiac arrest: A prospective observational study
| Autor: | Roger Siemund, Linda Knutsson, Elna-Marie Larsson, Hans Friberg, Hanna Järnum, Elisabet Englund, Malin Rundgren |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Adolescent Brain damage Emergency Nursing Return of spontaneous circulation Young Adult Hypothermia Induced Predictive Value of Tests Intensive care Humans Medicine Prospective Studies Coma Cerebral perfusion pressure Aged Aged 80 and over medicine.diagnostic_test business.industry Brain Magnetic resonance imaging Middle Aged Hypothermia Heart Arrest Survival Rate Diffusion Magnetic Resonance Imaging Treatment Outcome Cerebrovascular Circulation Anesthesia Emergency Medicine Female medicine.symptom Cardiology and Cardiovascular Medicine business Perfusion Follow-Up Studies |
| Zdroj: | Resuscitation. 80:425-430 |
| ISSN: | 0300-9572 |
| DOI: | 10.1016/j.resuscitation.2009.01.004 |
| Popis: | Background Outcome for resuscitated cardiac arrest (CA) patients is poor. The 1-year survival rate with favourable neurological outcome (CPC 1-2) after out-of-hospital CA is reported to be 4%. Among resuscitated patients treated within an ICU, approximately 50% regain consciousness, whereas the other 50% remain comatose before they die. Induced hypothermia significantly improves the neurological outcome and survival in patients with primary CA who remain comatose after return of spontaneous circulation. Aim To evaluate magnetic resonance imaging (MRI) changes in resuscitated CA patients remaining in coma after treatment with hypothermia. Methods This prospective, observational study comprised 20 resuscitated CA patients who remained in coma 3 days after being treated with mild hypothermia (32–34 °C during 24 h). Diffusion and perfusion MRI of the entire brain was performed approximately 5 days after CA. Autopsy was done on two patients. Results The largest number of diffusion changes on MRI was found in the 16 patients who died. The parietal lobe showed the largest difference in number of acute ischaemic MRI lesions in deceased compared with surviving patients. Perfusion changes, ≥±2 SD compared with healthy volunteers from a previously published cerebral perfusion study, were found in seven out of eight patients. The autopsies showed lesions corresponding to the pathologic changes seen on MRI. Conclusion Diffusion and perfusion MRI are potentially helpful tools for the evaluation of ischaemic brain damage in resuscitated comatose patients treated with hypothermia after CA. |
| Databáze: | OpenAIRE |
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