Hypothermia, Hypoxic Brain Injury
Conditions
Keywords
jugular venous oxygen saturation, hypothermia
Brief summary
The purpose of this study is to understand what happens to cerebral metabolism during therapeutic hypothermia for hypoxic brain injury following cardiac arrest.
Detailed description
Latest international guidelines recommend the use of therapeutic hypothermia in patients who have had cardiac arrest and remain in coma after return of spontaneous circulation. This is recommended essentially to limit the cerebral injury caused by cardiac arrest and possibly amplified upon reperfusion. At times, although a spontaneous circulation has returned, cerebral oxygenation may remain inadequate due to inadequate perfusion pressure, and hypothermia, by reducing cardiac output and cerebral blood flow could actually aggravate this phenomenon. The rewarming period is thought to be at greatest risk of inadequate oxygenation for the increase in metabolic demand. With this study we aim to understand what happens to cerebral oxygenation and metabolism during therapeutic hypothermia for cardiac arrest through cerebrovenous oxygen saturation monitoring and in particular, to see whether through this type of monitoring we could recognize otherwise unnoticed periods of inadequate cerebral oxygenation.
Interventions
Retrograde cannulation of jugular vein and intermittent sampling of venous blood from cerebral circulation before, during and after hypothermia.
Sponsors
Study design
Eligibility
Inclusion criteria
* Adult patients in coma after cardiac arrest undergoing therapeutic hypothermia
Exclusion criteria
* Age \< 18 * Pregnancy * Traumatic brain injury * Contraindications to cannulation as severe coagulopathy
Countries
Italy