Association between time-dependent changes in cerebrovascular autoregulation after cardiac arrest and outcomes : A prospective cohort study
This prospective observational single-center cohort study aimed to determine an association between cerebrovascular autoregulation (CVAR) and outcomes in hypoxic-ischemic brain injury post-cardiac arrest (CA), and assessed 100 consecutive post-CA patients in Japan between June 2017 and May 2020 who experienced a return of spontaneous circulation. Continuous monitoring was performed for 96 h to determine CVAR presence. A moving Pearson correlation coefficient was calculated from the mean arterial pressure and cerebral regional oxygen saturation. The association between CVAR and outcomes was evaluated using the Cox proportional hazard model; non-CVAR time percent was the time-dependent, age-adjusted covariate. The non-linear effect of target temperature management (TTM) was assessed using a restricted cubic spline. Of the 100 participants, CVAR was detected using the cerebral performance category (CPC) in all patients with a good neurological outcome (CPC 1-2) and in 65 patients (88%) with a poor outcome (CPC 3-5). Survival probability decreased significantly with increasing non-CVAR time percent. The TTM versus the non-TTM group had a significantly lower probability of a poor neurological outcome at 6 months with a non-CVAR time of 18%-37% (p < 0.05). Longer non-CVAR time may be associated with significantly increased mortality in hypoxic-ischemic brain injury post-CA.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
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| Enthalten in: |
Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism - 43(2023), 11 vom: 28. Nov., Seite 1942-1950 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tachino, Jotaro [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiac arrest |
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| Anmerkungen: |
Date Completed 09.11.2023 Date Revised 27.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/0271678X231185658 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM358784069 |
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| 100 | 1 | |a Tachino, Jotaro |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association between time-dependent changes in cerebrovascular autoregulation after cardiac arrest and outcomes |b A prospective cohort study |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a This prospective observational single-center cohort study aimed to determine an association between cerebrovascular autoregulation (CVAR) and outcomes in hypoxic-ischemic brain injury post-cardiac arrest (CA), and assessed 100 consecutive post-CA patients in Japan between June 2017 and May 2020 who experienced a return of spontaneous circulation. Continuous monitoring was performed for 96 h to determine CVAR presence. A moving Pearson correlation coefficient was calculated from the mean arterial pressure and cerebral regional oxygen saturation. The association between CVAR and outcomes was evaluated using the Cox proportional hazard model; non-CVAR time percent was the time-dependent, age-adjusted covariate. The non-linear effect of target temperature management (TTM) was assessed using a restricted cubic spline. Of the 100 participants, CVAR was detected using the cerebral performance category (CPC) in all patients with a good neurological outcome (CPC 1-2) and in 65 patients (88%) with a poor outcome (CPC 3-5). Survival probability decreased significantly with increasing non-CVAR time percent. The TTM versus the non-TTM group had a significantly lower probability of a poor neurological outcome at 6 months with a non-CVAR time of 18%-37% (p < 0.05). Longer non-CVAR time may be associated with significantly increased mortality in hypoxic-ischemic brain injury post-CA | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Cardiac arrest | |
| 650 | 4 | |a cerebrovascular autoregulation | |
| 650 | 4 | |a hypoxic-ischemic brain injury | |
| 650 | 4 | |a near-infrared spectroscopy | |
| 650 | 4 | |a single-center cohort study | |
| 700 | 1 | |a Nonomiya, Yuta |e verfasserin |4 aut | |
| 700 | 1 | |a Taniuchi, Satsuki |e verfasserin |4 aut | |
| 700 | 1 | |a Shintani, Ayumi |e verfasserin |4 aut | |
| 700 | 1 | |a Nakao, Shunichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Takegawa, Ryosuke |e verfasserin |4 aut | |
| 700 | 1 | |a Hirose, Tomoya |e verfasserin |4 aut | |
| 700 | 1 | |a Sakai, Tomohiko |e verfasserin |4 aut | |
| 700 | 1 | |a Ohnishi, Mitsuo |e verfasserin |4 aut | |
| 700 | 1 | |a Shimazu, Takeshi |e verfasserin |4 aut | |
| 700 | 1 | |a Shiozaki, Tadahiko |e verfasserin |4 aut | |
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