Cerebral blood flow is decoupled from blood pressure and linked to EEG bursting after resuscitation from cardiac arrest
Cerebral blood flow is decoupled from blood pressure and linked to EEG bursting after resuscitation from cardiac arrest
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DOI：
10.1364/boe.7.004660
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发表时间：
2016-11-01
影响因子：
3.4
通讯作者：
Akbari, Yama
中科院分区：
文献类型：
--
作者：
Crouzet, Christian;Wilson, Robert H.;Akbari, Yama
在本研究中，我们开发了一种多模态仪器，将激光散斑成像、动脉血压和脑电图（EEG）结合起来，定量评估窒息性心脏骤停（CA）和复苏之前、期间和之后的脑血流量（CBF）、平均动脉压（MAP）和脑电生理。利用获得的数据，我们量化了CBF充血高峰的时间和幅度，并在复苏后稳定了低灌注。此外，我们评估了稳定低灌注前后CBF和MAP的相关性。最后，我们研究了CA复苏后脑电活动恢复时间与CBF和MAP的关系，并建立了预测CA复苏后脑电活动恢复时间的经验预测模型。结果表明：1)CA越严重，稳定脑低灌注的时间越长；2)稳定低灌注前CBF与MAP耦合，稳定低灌注后CBF与MAP不耦合；3)脑电图活动（爆发）在脑血流充血期后和稳定低灌注前恢复；4) CBF预测5分钟窒息性CA的脑电图活动恢复时间，但对7分钟窒息性CA的预测能力较差。总之，这些新发现强调了使用多模态方法研究CA恢复以更好地了解生理过程并最终改善神经预后的重要性。(C) 2016年美国光学学会
In the present study, we have developed a multi-modal instrument that combines laser speckle imaging, arterial blood pressure, and electroencephalography (EEG) to quantitatively assess cerebral blood flow (CBF), mean arterial pressure (MAP), and brain electrophysiology before, during, and after asphyxial cardiac arrest (CA) and resuscitation. Using the acquired data, we quantified the time and magnitude of the CBF hyperemic peak and stabilized hypoperfusion after resuscitation. Furthermore, we assessed the correlation between CBF and MAP before and after stabilized hypoperfusion. Finally, we examined when brain electrical activity resumes after resuscitation from CA with relation to CBF and MAP, and developed an empirical predictive model to predict when brain electrical activity resumes after resuscitation from CA. Our results show that: 1) more severe CA results in longer time to stabilized cerebral hypoperfusion; 2) CBF and MAP are coupled before stabilized hypoperfusion and uncoupled after stabilized hypoperfusion; 3) EEG activity (bursting) resumes after the CBF hyperemic phase and before stabilized hypoperfusion; 4) CBF predicts when EEG activity resumes for 5-min asphyxial CA, but is a poor predictor for 7-min asphyxial CA. Together, these novel findings highlight the importance of using multi-modal approaches to investigate CA recovery to better understand physiological processes and ultimately improve neurological outcome. (C) 2016 Optical Society of America