Acute Brain Injury, Cardiac Arrest (CA), Extracorporeal Cardiopulmonary Resuscitation
Conditions
Keywords
Cardiac Arrest, Extracorporeal Cardiopulmonary Resuscitation, Acute brain injury, Magnetic Resonance Imaging
Brief summary
Timely identification of acute brain injury (ABI) patterns in patients with extracorporeal cardiopulmonary resuscitation (ECPR) is essential for prognostic assessment and optimization of clinical management, particularly anticoagulation strategies. This study aimed to evaluate the safety and feasibility of early 0.23-T MRI examination in ECPR patients. The investigators further assessed the image quality of the 0.23-T MRI and investigated the incidence and patterns of ABI, as well as their associations with neurological outcomes. This prospective observational study was conducted in the emergency intensive care unit (EICU) of Beijing Chaoyang Hospital, a high-volume ECPR center. The primary outcome was the feasibility of performing 0.23-T MRI in patients undergoing ECPR, defined as successful completion of the examination without serious adverse events (AEs).
Interventions
None listed
Sponsors
Capital Medical University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Enrolled patients were those with out-of-hospital cardiac arrest of presumed cardiac cause, supported by ECPR, who achieved ROSC but remained unconscious and unable to obey verbal commands.
Exclusion criteria
* age \< 18 years * unwitnessed cardiac arrest * pregnancy * contraindications to MRI (except ECPR, for which safety with 0.23-T MRI has been proved) * physical dimensions exceeding scanner limits * refusal of consent by the family
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of 0.23-T MRI examination | From the initiation of the MRI scan until 6 hours after its completion. | Defined as the percentage of participants who successfully complete the MRI examination without experiencing serious adverse events (AEs). AEs include a decrease in ECMO flow \> 10%, a change in mean arterial pressure of ± 20%, or a change in minute ventilation \> 20%. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Image Quality | Within 6 hours after the completion of the MRI scan. | Assessment of the diagnostic quality of 0.23-T MRI images by board-certified neuroradiologists to evaluate noise, artifacts, and anatomical clarity. |
| Incidence of Acute Brain Injury (ABI) | From the onset of cardiac arrest to the completion of the MRI scan | The proportion of patients identified with ABI patterns (such as ischemic stroke, intracranial hemorrhage, or cerebral edema) based on 0.23-T MRI findings. |
| The association between ABI and neurological outcomes | 3 months after ROSC. | Neurological outcomes were assessed at 3 months after ROSC using the Glasgow-Pittsburgh Cerebral Performance Category (CPC) scale. The CPC scale ranges from 1 to 5, with 1 indicating good performance, 2 indicating moderate disability, 3 indicating severe disability, 4 indicating vegetative state and 5 indicating brain death or death. The neurological outcomes were categorized as favorable prognosis (CPC 1-2) and poor prognosis (CPC 3-5). |
Countries
China
Outcome results
None listed