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Iordanova B, Li L, Clark RSB, et al. Alterations in Cerebral Blood Flow after Resuscitation from Cardiac Arrest. Front Pediatr. 2017;5:174doi: 10.3389/fped.2017.00174.
Iordanova, B., Li, L., Clark, R. S. B., & Manole, M. D. (2017). Alterations in Cerebral Blood Flow after Resuscitation from Cardiac Arrest. Frontiers in pediatrics, 5174. https://doi.org/10.3389/fped.2017.00174
Iordanova, Bistra, et al. "Alterations in Cerebral Blood Flow after Resuscitation from Cardiac Arrest." Frontiers in pediatrics vol. 5 (2017): 174. doi: https://doi.org/10.3389/fped.2017.00174
Iordanova B, Li L, Clark RSB, Manole MD. Alterations in Cerebral Blood Flow after Resuscitation from Cardiac Arrest. Front Pediatr. 2017 Aug 16;5:174. doi: 10.3389/fped.2017.00174. eCollection 2017. PMID: 28861407; PMCID: PMC5561008.
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Front Pediatr. 2017 Aug 16;5:174. doi: 10.3389/fped.2017.00174. eCollection 2017.

Alterations in Cerebral Blood Flow after Resuscitation from Cardiac Arrest.

Frontiers in pediatrics

Bistra Iordanova, Lingjue Li, Robert S B Clark, Mioara D Manole

Affiliations

  1. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States.
  2. School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United States.
  3. Safar Center for Resuscitation Research, Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United States.
  4. Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States.

PMID: 28861407 PMCID: PMC5561008 DOI: 10.3389/fped.2017.00174

Abstract

Greater than 50% of patients successfully resuscitated from cardiac arrest have evidence of neurological disability. Numerous studies in children and adults, as well as in animal models have demonstrated that cerebral blood flow (CBF) is impaired after cardiac arrest. Stages of cerebral perfusion post-resuscitation include early hyperemia, followed by hypoperfusion, and finally either resolution of normal blood flow or protracted hyperemia. At the level of the microcirculation the blood flow is heterogeneous, with areas of no flow, low flow, and increased flow. CBF directed therapies in animal models of cardiac arrest improved neurological outcome, and therefore, the alterations in CBF after cardiac arrest likely contribute to the development of hypoxic ischemic encephalopathy. Current intensive care after cardiac arrest is centered upon maintaining systemic oxygenation, normal blood pressure values for age, maintaining general homeostasis, and avoiding hyperthermia. Assessment of CBF and oxygenation is not routinely performed after cardiac arrest. Currently available and underutilized techniques to assess cerebral perfusion include transcranial doppler, near-infrared spectroscopy, and arterial spin labeling magnetic resonance imaging. Limited clinical studies established the role of CBF and oxygenation monitoring in prognostication after cardiac arrest and few studies suggest that guiding critical care post-resuscitation to mean arterial pressures above the minimal autoregulatory range might improve outcome. Important knowledge gaps thus remain in cerebral monitoring and CBF and oxygen goal-directed therapies post-resuscitation from cardiac arrest.

Keywords: arterial spin labeling; cardiac arrest; cerebral blood flow; cerebral perfusion; hyperemia; hypoperfusion; post-cardiac arrest syndrome; transcrianial Doppler

References

  1. Stroke. 2001 Jan;32(1):128-32 - PubMed
  2. Stroke. 1992 Jan;23(1):45-53 - PubMed
  3. J Neurosurg. 2000 Aug;93(2):265-74 - PubMed
  4. Crit Care Med. 2003 Aug;31(8):2211-21 - PubMed
  5. Stroke. 1981 Jan-Feb;12(1):66-72 - PubMed
  6. Top Magn Reson Imaging. 2015 Oct;24(5):275-87 - PubMed
  7. J Cereb Blood Flow Metab. 1991 Mar;11(2):272-82 - PubMed
  8. Acta Neurochir Suppl (Wien). 1994;60:184-6 - PubMed
  9. Resuscitation. 2014 Oct;85(10):1387-93 - PubMed
  10. Am J Pathol. 1968 Feb;52(2):437-53 - PubMed
  11. Sci Data. 2015 Feb 03;2:150003 - PubMed
  12. Resuscitation. 2015 Apr;89:182-7 - PubMed
  13. Anesth Analg. 1989 Apr;68(4):436-43 - PubMed
  14. Stroke. 2009 May;40(5):1820-6 - PubMed
  15. J Cereb Blood Flow Metab. 1985 Sep;5(3):420-31 - PubMed
  16. Resuscitation. 2009 Jun;80(6):701-6 - PubMed
  17. Crit Care Med. 2009 Aug;37(8):2333-7 - PubMed
  18. J Neurol. 1980 Jan;222(3):159-70 - PubMed
  19. Pediatr Res. 2006 Sep;60(3):359-63 - PubMed
  20. Acta Anaesthesiol Scand. 1996 May;40(5):631-5 - PubMed
  21. Circ Res. 1967 Jan;20(1):124-35 - PubMed
  22. Resuscitation. 2014 Apr;85(4):516-21 - PubMed
  23. Crit Care Med. 2000 Aug;28(8):2873-80 - PubMed
  24. Stroke. 1997 Aug;28(8):1569-73 - PubMed
  25. Conf Proc IEEE Eng Med Biol Soc. 2015;2015:6971-4 - PubMed
  26. J Hirnforsch. 1994;35(4):463-71 - PubMed
  27. Resuscitation. 1988 Apr;16(2):107-18 - PubMed
  28. Arch Neurol. 1976 Feb;33(2):91-5 - PubMed
  29. Resuscitation. 1990 Dec;20(3):203-12 - PubMed
  30. Curr Neurovasc Res. 2007 Feb;4(1):49-54 - PubMed
  31. Stroke. 2007 Oct;38(10):2818-25 - PubMed
  32. Resuscitation. 2008 Dec;79(3):350-79 - PubMed
  33. J Cereb Blood Flow Metab. 1983 Jun;3(2):170-82 - PubMed
  34. Brain Res. 1993 Aug 20;620(1):122-6 - PubMed
  35. Acta Neurochir (Wien). 1989;100(1-2):12-24 - PubMed
  36. Resuscitation. 2009 Apr;80(4):425-30 - PubMed
  37. J Neurosurg. 1973 Feb;38(2):131-44 - PubMed
  38. Pediatr Radiol. 2011 May;41 Suppl 1:S153-65 - PubMed
  39. J Magn Reson Imaging. 2015 Jun;41(6):1591-600 - PubMed
  40. AJNR Am J Neuroradiol. 2014 Mar;35(3):593-8 - PubMed
  41. Neth J Med. 2000 Sep;57(3):106-12 - PubMed
  42. Resuscitation. 1989 Apr;17(2):105-17 - PubMed
  43. Prog Brain Res. 2016;225:213-42 - PubMed
  44. Biomed Opt Express. 2016 Oct 20;7(11):4660-4673 - PubMed
  45. Acta Anaesthesiol Scand. 1996 Oct;40(9):1149-53 - PubMed
  46. Stroke. 1975 Jan-Feb;6(1):21-7 - PubMed
  47. Stroke. 2008 May;39(5):1556-62 - PubMed
  48. Stroke. 1989 Jun;20(6):761-5 - PubMed
  49. AJNR Am J Neuroradiol. 2008 Aug;29(7):1302-7 - PubMed
  50. Resuscitation. 2015 Feb;87:38-43 - PubMed
  51. Resuscitation. 2015 Dec;97:1-6 - PubMed
  52. Pediatrics. 2000 Oct;106(4):625-32 - PubMed
  53. J Cereb Blood Flow Metab. 2015 Nov;35(11):1757-63 - PubMed
  54. Resuscitation. 2014 Jul;85(7):964-71 - PubMed
  55. J Appl Physiol. 1954 Jun;6(12):731-44 - PubMed
  56. Stroke. 1979 Sep-Oct;10(5):554-60 - PubMed
  57. J Neurosci. 2012 Apr 4;32(14):4972-81 - PubMed
  58. Stroke. 1987 Sep-Oct;18(5):869-78 - PubMed
  59. J Cereb Blood Flow Metab. 2001 Nov;21(11):1320-9 - PubMed
  60. J Am Heart Assoc. 2016 Jan 04;5(1):null - PubMed
  61. Resuscitation. 1992 Aug-Sep;24(1):27-47 - PubMed
  62. Crit Care Med. 2011 Oct;39(10):2337-45 - PubMed
  63. Stroke. 1975 May-Jun;6(3):245-56 - PubMed
  64. Intensive Care Med. 1995 Feb;21(2):132-41 - PubMed
  65. Acta Anaesthesiol Sin. 2000 Mar;38(1):47-51 - PubMed
  66. Resuscitation. 1997 Feb;34(1):79-87 - PubMed
  67. J Neurosurg. 2003 Jun;98(6):1227-34 - PubMed
  68. J Cereb Blood Flow Metab. 2009 Jan;29(1):197-205 - PubMed
  69. Resuscitation. 2015 May;90:121-6 - PubMed
  70. Resuscitation. 1992 Feb;23 (1):1-20 - PubMed
  71. Crit Care Med. 1997 Jun;25(6):971-6 - PubMed
  72. Rev Electroencephalogr Neurophysiol Clin. 1974 Apr-Jun;4(2):329-33 - PubMed
  73. Resuscitation. 2008 Jan;76(1):17-24 - PubMed
  74. Resuscitation. 2008 May;77(2):229-34 - PubMed
  75. Br J Anaesth. 2009 Dec;103 Suppl 1:i3-13 - PubMed
  76. Shock. 2016 Jun;45(6):613-9 - PubMed
  77. Neurogenesis (Austin). 2016 Oct 28;3(1):e1244439 - PubMed
  78. Resuscitation. 2015 Nov;96:192-8 - PubMed
  79. Pediatr Res. 2014 Feb;75(2):295-301 - PubMed
  80. Chest. 2005 May;127(5):1812-27 - PubMed
  81. Intensive Care Med. 1996 Nov;22(11):1214-23 - PubMed
  82. Invest Radiol. 1977 Jul-Aug;12(4):325-32 - PubMed
  83. Resuscitation. 2009 Nov;80(11):1321-2 - PubMed
  84. J Pediatr. 2016 Feb;169:28-35.e1 - PubMed
  85. Pediatr Res. 2017 Jan;81(1-1):94-98 - PubMed
  86. Stroke. 1978 Nov-Dec;9(6):569-73 - PubMed

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