• Journal of critical care · Jun 2019

    Multicenter Study

    Usefulness of a quantitative analysis of the cerebrospinal fluid volume proportion in brain computed tomography for predicting neurological prognosis in cardiac arrest survivors who undergo target temperature management.

    • Yeon Ho You, Jung Soo Park, In Sool Yoo, Jin Hong Min, Won Joon Jeong, Yong Chul Cho, Seung Ryu, Jin Woong Lee, Seung Whan Kim, Sung Uk Cho, Se Kwang Oh, Hong Joon Ahn, Yong Nam In, Chi Hwan Kwack, Kyung Sik Yi, Dong Hoon Lee, Byung Kook Lee, Kyung Hye Park, In Ho Lee, Sun Moon Kim, and In Sun Kwon.
    • Department of Emergency Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, Republic of Korea.
    • J Crit Care. 2019 Jun 1; 51: 170-174.

    PurposeBrain swelling post-cardiac arrest may affect cerebrospinal fluid volume. We aimed to investigate the prognostic performance of the proportion of cerebrospinal fluid volume (pCSFV) using brain computed tomography (CT) in cardiac arrest survivors.Materials And MethodsThis retrospective multicentre study included adult comatose cardiac arrest survivors who underwent brain CT scan prior to target temperature management (TTM) from 2015 to 2016. Grey-to-white matter ratio (GWR) and pCSFV values were calculated. pCSFV analysis was performed using automated quantitative analysis programming. The primary outcome was a 6-month neurological outcome.ResultsOf 251 patients (median age, 57 years), 173 (68.9%) were male, 87 (34.7%) had a shockable rhythm, and 160 (63.7%) had unfavourable neurological outcomes. GWR but not pCSFV was significantly higher in terms of favourable neurological outcomes (p = .015). pCSFV prognostic performances were similar to GWR, and were poor overall, (0.521; 95% confidence interval [CI], 0.446-0.694 vs. 0.515; 95% CI, 0.441-0.589). After adjusting for covariates, pCSFV but not GWR was independently associated with neurological outcome 6 months following cardiac arrest (p = .049).ConclusionpCSFV was independently associated with neurological outcome 6 months following cardiac arrest, however prognostic performance was not good.Copyright © 2019 Elsevier Inc. All rights reserved.

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