Acute Cerebral Blood Flow Variations after Human Cardiac Arrest Assessed by Stable Xenon Enhanced Computed Tomography

Yoshiaki      Inoue; Tadahiko      Shiozaki; Taro      Irisawa; Tomoyoshi      Mohri; Kazuhisa      Yoshiya; Hitoshi      Ikegawa; Osamu      Tasaki; Hiroshi      Tanaka; Takeshi      Shimazu; Hisashi      Sugimoto

doi:10.2174/156720207779940725

Abstract

In this study, changes in cerebral blood flow (CBF) during acute phase after cardiopulmonary arrest (CPA) were examined in patients using stable Xenon enhanced computed tomography (Xe-CT). All patients (8) were stabilized hemodynamically within 4 hours after admission, and Xe-CT was performed immediately after restoration of spontaneous circulation (ROSC) at 8, 24, 48, 96 and 168 hours after ROSC. The progress of patients was monitored in other hospitals and clinics after discharge. Neurological outcomes were evaluated using the Glasgow outcome scale (GOS) 6 months after admission, and scores were compared against changes in CBF. Patients were grouped by prognosis. Four patients belonged to Group A (good recovery) and Group B (2 severely disabled, 2 in persistent vegetative state). The pattern of change in CBF after ROSC was found to be significantly different between Groups A and B (p < 0.05). The CBF ratio relative to normal controls was higher in Group B than Group A within 48 hours after ROSC. However, at 48, 96, and 168 hours after ROSC, the opposite was observed: The CBF ratio was significantly higher in Group A than Group B (p < 0.05). Based on these results, we concluded that CBF in the patients who survived after CPA changed remarkable especially within the first week. Furthermore, patients with abnormally low CBF that returns to supernormal within the first 48 hours following CPA can be expected to recover well neurologically.

Keywords: Cerebral blood flow, cardiopulmonary arrest, anoxic coma, neurological outcome, xenon enhanced computed tomography, recovery from cerebral hypoperfusion

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