Blood-brain barrier permeability for the first 24 hours in hypoxic-ischemic brain injury following cardiac arrest

This study aimed to explore the changes in blood–brain barrier (BBB) permeability and intracranial pressure (ICP) for the first 24 h after the return of spontaneous circulation (ROSC) and their association with injury severity of cardiac arrest. This prospective study analysed the BBB permeability a...

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Bibliographic Details
Published in:Resuscitation 2024-05, Vol.198, p.110150-110150, Article 110150
Main Authors: You, Yeonho, Park, Jung Soo, Min, Jin Hong, Jeong, Wonjoon, Ahn, Hong Joon, In, Yong Nam, Jeon, So Young, Lee, Jae Kwang, Kang, Changshin
Format: Article
Language:English
Subjects:
Aged
Blood-Brain Barrier - metabolism
Blood-Brain Barrier - physiopathology
Blood–brain barrier
Brain
Capillary Permeability - physiology
Cardiac arrest
Cardiopulmonary Resuscitation - adverse effects
Cardiopulmonary Resuscitation - methods
Female
Heart Arrest - etiology
Heart Arrest - physiopathology
Heart Arrest - therapy
Humans
Hypoxia-Ischemia, Brain - etiology
Hypoxia-Ischemia, Brain - physiopathology
Hypoxia–ischaemia
Intracranial Pressure - physiology
Male
Middle Aged
Prospective Studies
Return of Spontaneous Circulation
Time Factors
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Summary:This study aimed to explore the changes in blood–brain barrier (BBB) permeability and intracranial pressure (ICP) for the first 24 h after the return of spontaneous circulation (ROSC) and their association with injury severity of cardiac arrest. This prospective study analysed the BBB permeability assessed using the albumin quotient (Qa) and ICP every 2 h for the first 24 h after ROSC. The injury severity of cardiac arrest was assessed using Pittsburgh Cardiac Arrest Category (PCAC) scores. The primary outcome was the time course of changes in the BBB permeability and ICP for the first 24 h after ROSC and their association with injury severity (PCAC scores of 1–4). Qa and ICP were measured 274 and 197 times, respectively, in 32 enrolled patients. Overall, the BBB permeability increased progressively over time after ROSC, and then it increased significantly at 18 h after ROSC compared with the baseline. In contrast, the ICP revealed non-significant changes for the first 24 h after ROSC. The Qa in the PCAC 2 group was 
ISSN:0300-9572
1873-1570
DOI:10.1016/j.resuscitation.2024.110150