Intracranial Pressure and Cerebral Hemodynamic Monitoring After Cardiac Arrest in Pediatric Pigs Using Contrast Ultrasound‐Derived Parameters

2021 ◽  
Author(s):  
Samuel S. Shin ◽  
Anush Sridharan ◽  
Kristina Khaw ◽  
Thomas Hallowell ◽  
Ryan W. Morgan ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Intracranial Pressure ◽  
Hemodynamic Monitoring ◽  
Cerebral Hemodynamic ◽  
Contrast Ultrasound

173: NONINVASIVE DIFFUSE OPTICS FOR CEREBRAL HEMODYNAMIC MONITORING IN CHILDREN AFTER CARDIAC ARREST

2020 ◽  
Vol 48 (1) ◽  
pp. 69-69
Author(s):  
Nir Atlas ◽  
Kyle Cowdrick ◽  
Kaitlin Chance ◽  
Eashani Sathialingam ◽  
Seung Lee ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hemodynamic Monitoring ◽  
Diffuse Optics ◽  
Cerebral Hemodynamic

Abstract 114: Effect of Body Position on Intracranial Pressure and Carotid Blood Flow During Extracorporeal Cardiopulmonary Resuscitation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Yaël Levy ◽  
Rocio Fernandez ◽  
Fanny Lidouren ◽  
Matthias Kohlhauer ◽  
Lionel Lamhaut ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Arrest ◽  
Intracranial Pressure ◽  
Cardiopulmonary Resuscitation ◽  
Body Position ◽  
Spontaneous Circulation ◽  
Systemic Hemodynamics ◽  
Body Tilt ◽  
Whole Body ◽  
Extracorporeal Cardiopulmonary Resuscitation

Introduction: Extracorporeal cardiopulmonary resuscitation (E-CPR) using extracorporeal membrane oxygenation (ECMO) is widely proposed for the treatment of refractory cardiac arrest. Hypothesis: Since cerebral autoregulation is altered in such conditions, body position may modify hemodynamics during ECPR. Our goal was to determine whether a whole body tilt-up challenge (TUC) could lower intracranial pressure (ICP) as previously shown with conventional CPR, without deteriorating cerebral blood flow (CBF). Methods: Pigs were anesthetized and instrumented for the continuous evaluation of CBF, ICP and systemic hemodynamics. After 15 min of untreated ventricular fibrillation they were treated with 30 min of E-CPR followed by sequential defibrillation shocks until resumption of spontaneous circulation (ROSC). ECMO was continued after ROSC to target a mean arterial pressure (MAP) >60 mmHg. Animals were maintained in the flat position (FP) throughout protocol, except during a 2 min TUC of the whole body (+30°) at baseline, during E-CPR and after-ROSC. Results: Four animals received the entire procedure and ROSC was obtained in 3/4. After cardiac arrest, E-CPR was delivered at 29±2 ml/kg/min to maintain a MAP of 57±8 mmHg in the FP. CBF was 28% of baseline and ICP remain stable (12±1 vs 13±1 mmHg during ECPR vs baseline, respectively). Under baseline pre-arrest conditions TUC resulted in a significant decrease in ICP (-63±7%) and CBF (-21±3%) versus the FP, with no significant effect on systemic hemodynamics. During E-CPR and after ROSC, TUC markedly reduced ICP but CBF remained unchanged vs the FP (Figure). Conclusion: During E-CPR whole body TUC reduced ICP without lowering CBF compared with E-CPR flat. Additional investigations with prolonged TUC and selective head and thorax elevation during E-CPR are warranted.

Near-infrared spectroscopy: a tool to monitor cerebral hemodynamic and metabolic changes after cardiac arrest in rats

Resuscitation ◽  
2004 ◽  
Vol 63 (2) ◽  
pp. 213-220 ◽  
Author(s):  
Feng Xiao ◽  
Juan Rodriguez ◽  
Thomas C. Arnold ◽  
Shu Zhang ◽  
Davon Ferrara ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Metabolic Changes ◽  
Cerebral Hemodynamic

scholarly journals Rapid Brain Death following Cardiac Arrest without Intracranial Pressure Rise and Cerebral Circulation Arrest

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Maxime Nguyen ◽  
Thomas Bièvre ◽  
Abdelouaid Nadji ◽  
Bélaïd Bouhemad
Keyword(s):  
Cardiac Arrest ◽  
Intracranial Pressure ◽  
Brain Death ◽  
Unusual Case ◽  
Neuronal Damage ◽  
Pressure Rise ◽  
Electric Activity ◽  
Cellular Toxicity ◽  
Intracranial Pressure Elevation ◽  
Brain Reperfusion

We describe here an unusual case of brain death following cardiac arrest. Brain electric activity had totally ceased, allowing the confirmation of brain death, despite normal cerebral blood flow (assessed by both transcranial doppler and tomodensitometry) and no evidence of intracranial hypertension. In our case, a residual electric activity was assessed at admission and lesions worsened on imaging during ICU stay, suggesting that part of the neuronal damage occurred after brain reperfusion. All these elements suggest BD rather by cellular toxicity than intracranial pressure elevation.

Use of High Frequency Jet Ventilation during Mechanical Hyperventilation to Reduce Intracranial Pressure in Patients with Multiple Organ System Injury

Neurosurgery ◽  
1984 ◽  
Vol 15 (4) ◽  
pp. 530-534 ◽  
Author(s):  
James M. Hurst ◽  
Thomas G. Saul ◽  
Bryan C. DeHaven ◽  
Rich Branson
Keyword(s):  
Cardiac Output ◽  
Intracranial Pressure ◽  
Hemodynamic Monitoring ◽  
Oxygen Delivery ◽  
High Frequency ◽  
Multiple Organ ◽  
Organ System ◽  
Jet Ventilation ◽  
Multiple Organ System ◽  
High Frequency Jet Ventilation

Abstract Eleven patients with multiple organ system injury, including significant closed head injury, all required positive end-expiratory pressure (PEEP) for treatment of their pulmonary pathological condition, Additionally, the need for intracranial pressure (ICP) monitoring had previously been established on clinical evaluation by the Neurosurgery Service. Seven of the 11 patients met the criteria for invasive hemodynamic monitoring. Hemodynamic monitoring data are supplied for these 7 patients. All patients, after the initial institution of conventional means of hyperventilation, were transitioned to high frequency jet ventilation (HFJV) to evaluate the effects of HFJV during mechanical hyperventilation, There was a statistically significant decrease in ICP (mean decrease of 7.2 mm Hg). There was also a statistically significant fall in PaO2 from 131 to 101 torr. This was not associated with an appreciable decrease in oxygen delivery. There was no change in cardiac output or intrapulmonary shunt fraction. It is concluded that successful control of ICP was possible in all cases without impairment of cardiac output, oxygen delivery, or cerebral perfusion pressure, even when the pulmonary abnormality required the use of PEEP.

The use of invasive hemodynamic monitoring in evaluating resuscitative endpoints in post-cardiac arrest patients

Resuscitation ◽  
2012 ◽  
Vol 83 ◽  
pp. e93-e94 ◽  
Author(s):  
Sarah Perman ◽  
Anne Grossestreuer ◽  
Marion Leary ◽  
Maria Beylin ◽  
Benjamin Abella ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hemodynamic Monitoring ◽  
Invasive Hemodynamic Monitoring

scholarly journals A comparison of non-invasive versus invasive measures of intracranial pressure in hypoxic ischaemic brain injury after cardiac arrest

Resuscitation ◽  
2019 ◽  
Vol 137 ◽  
pp. 221-228 ◽  
Author(s):  
Danilo Cardim ◽  
Donald E. Griesdale ◽  
Philip N. Ainslie ◽  
Chiara Robba ◽  
Leanne Calviello ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Non Invasive ◽  
Ischaemic Brain ◽  
Ischaemic Brain Injury
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