Brain Death and Its Prediction in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature Management
Evolution toward brain death (BD) in out-of-hospital cardiac arrest patients with targeted temperature management (TTM) provides opportunities for organ donation. However, knowledge regarding BD in these patients is limited. We retrospectively analyzed the TTM registry of one hospital where life-sus...
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| Format: | Article |
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MDPI AG
2022-05-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/5/1190 |
| _version_ | 1797500411153743872 |
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| author | Hwan Song Sang Hoon Oh Hye Rim Woo on behalf of CROWN Investigators |
| author_facet | Hwan Song Sang Hoon Oh Hye Rim Woo on behalf of CROWN Investigators |
| author_sort | Hwan Song |
| collection | DOAJ |
| description | Evolution toward brain death (BD) in out-of-hospital cardiac arrest patients with targeted temperature management (TTM) provides opportunities for organ donation. However, knowledge regarding BD in these patients is limited. We retrospectively analyzed the TTM registry of one hospital where life-sustaining therapy was not withdrawn. In-hospital death patients were categorized into BD and non-BD groups. We explored the process of evolution toward BD and its predictors by comparing the serial measurements of clinical variables and the results of various prognostic tests between the two groups. Of the 121 patients who died before hospital discharge, 19 patients (15.7%) developed BD at a median of 6 (interquartile range, 5.0–7.0) days after cardiac arrest. Four patients with pupillary light reflexes at 48 h eventually developed BD. The area under the curves of the gray-to-white matter ratio (GWR) on early brain computed tomography images and the level of S100 calcium-binding protein B (S100B) at 72 h were 0.67 (95% CI, 0.55–0.77) and 0.70 (95% CI, 0.55–0.83), respectively. In conclusion, approximately one-sixth of all in-hospital deaths were diagnosed with BD at a median of 6 days after cardiac arrest. The use of GWR and serial S100B measurements may help to screen potential BD. |
| first_indexed | 2024-03-10T03:02:29Z |
| format | Article |
| id | doaj.art-01d694361a864748b4e969c59f0594f4 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T03:02:29Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-01d694361a864748b4e969c59f0594f42023-11-23T10:40:39ZengMDPI AGDiagnostics2075-44182022-05-01125119010.3390/diagnostics12051190Brain Death and Its Prediction in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature ManagementHwan Song0Sang Hoon Oh1Hye Rim Woo2on behalf of CROWN InvestigatorsDepartment of Emergency Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, KoreaDepartment of Emergency Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, KoreaDepartment of Emergency Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, KoreaEvolution toward brain death (BD) in out-of-hospital cardiac arrest patients with targeted temperature management (TTM) provides opportunities for organ donation. However, knowledge regarding BD in these patients is limited. We retrospectively analyzed the TTM registry of one hospital where life-sustaining therapy was not withdrawn. In-hospital death patients were categorized into BD and non-BD groups. We explored the process of evolution toward BD and its predictors by comparing the serial measurements of clinical variables and the results of various prognostic tests between the two groups. Of the 121 patients who died before hospital discharge, 19 patients (15.7%) developed BD at a median of 6 (interquartile range, 5.0–7.0) days after cardiac arrest. Four patients with pupillary light reflexes at 48 h eventually developed BD. The area under the curves of the gray-to-white matter ratio (GWR) on early brain computed tomography images and the level of S100 calcium-binding protein B (S100B) at 72 h were 0.67 (95% CI, 0.55–0.77) and 0.70 (95% CI, 0.55–0.83), respectively. In conclusion, approximately one-sixth of all in-hospital deaths were diagnosed with BD at a median of 6 days after cardiac arrest. The use of GWR and serial S100B measurements may help to screen potential BD.https://www.mdpi.com/2075-4418/12/5/1190heart arrestinduced hypothermiaprognosticationbrain deathorgan transplantation |
| spellingShingle | Hwan Song Sang Hoon Oh Hye Rim Woo on behalf of CROWN Investigators Brain Death and Its Prediction in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature Management Diagnostics heart arrest induced hypothermia prognostication brain death organ transplantation |
| title | Brain Death and Its Prediction in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature Management |
| title_full | Brain Death and Its Prediction in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature Management |
| title_fullStr | Brain Death and Its Prediction in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature Management |
| title_full_unstemmed | Brain Death and Its Prediction in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature Management |
| title_short | Brain Death and Its Prediction in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature Management |
| title_sort | brain death and its prediction in out of hospital cardiac arrest patients treated with targeted temperature management |
| topic | heart arrest induced hypothermia prognostication brain death organ transplantation |
| url | https://www.mdpi.com/2075-4418/12/5/1190 |
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