Real-time quantitative monitoring of cerebral blood flow by laser speckle contrast imaging after cardiac arrest with targeted temperature management

Abstract

Brain injury is the main cause of mortality and morbidity after cardiac arrest (CA). Changes in cerebral blood flow (CBF) after reperfusion are associated with brain injury and recovery. To characterize the relative CBF (rCBF) after CA, 14 rats underwent 7 min asphyxia-CA and were randomly treated with 6 h post-resuscitation normothermic (36.5-37.5℃) or hypothermic- (32-34℃) targeted temperature management (TTM) (N = 7). rCBF was monitored by a laser speckle contrast imaging (LSCI) technique. Brain recovery was evaluated by neurologic deficit score (NDS) and quantitative EEG - information quantity (qEEG-IQ). There were regional differences in rCBF among veins of distinct cerebral areas and heterogeneous responses among the three components of the vascular system. Hypothermia immediately following return of spontaneous circulation led to a longer hyperemia duration (19.7 ± 1.8 vs. 12.7 ± 0.8 min, p < 0.01), a lower rCBF (0.73 ± 0.01 vs. 0.79 ± 0.01; p < 0.001) at the hypoperfusion phase, a better NDS (median [25th-75th], 74 [61-77] vs. 49 [40-77], p < 0.01), and a higher qEEG-IQ (0.94 ± 0.02 vs. 0.77 ± 0.02, p < 0.001) compared with normothermic TTM. High resolution LSCI technique demonstrated hypothermic TTM extends hyperemia duration, delays onset of hypoperfusion phase and lowered rCBF, which is associated with early restoration of electrophysiological recovery and improved functional outcome after CA.

Neuroprotection of Glibenclamide against Brain Injury after Cardiac Arrest via Modulation of NLRP3 Inflammasome

“…Electroencephalography (EEG) is an important method to predict the prognosis of hypoxicischemic brain damage based on its real-time evaluation of neurological function. We have also shown that quantitative EEG (qEEG) is a powerful prognostic marker for brain recovery after CA [5,[7][8][9][10][11].…”

“…Current clinical treatments include many mechanism-driven therapies, like hypothermia, that aim to improve the survival rate and neurological recovery after CA. We have previously developed multimodal monitoring including neurophysiological signal and CBF recording, to evaluate the hypoxia-induced cerebral damage, and to track brain injury and recovery after CA [4][5][6][7]. Electroencephalography (EEG) is an important method to predict the prognosis of hypoxicischemic brain damage based on its real-time evaluation of neurological function.…”

A Novel Rat Model for Cerebral Venous Sinus Thrombosis Matched Clinical Syndrome: Combination of Clinical Cases and Experimental Validation

“…The observation region was illuminated using a laser light source. Speckle signals (exposure time =10 ms) were continuously collected by the camera and then transmitted to a computer for analysis [14]. To avoid skull impediments to LSCI observation, the skull in the observation region (15 mm×10 mm) was thinned until the blood vessels were clearly visible.…”

Intracerebroventricular Administration of hNSCs Improves Neurological Recovery after Cardiac Arrest in Rats

“…Assessment of neurological recovery was performed using wellvalidated neurological deficit scores (NDS) with a total score of 80 [21,25]. The evaluations were conducted at four-time points of 6, 24, 48 and 72 h from ROSC.…”