predicting outcome in comatose patients after successful cardiopulmonary resuscitation is challenging. our primary aim was to assess the potential contribution of resting-state-functional magnetic resonance imaging (RS-fMRI) in predicting neurological outcome. RS-fMRI was used to evaluate functional and effective connectivity within the default mode network in a cohort of 90 comatose patients and their impact on functional neurological outcome after 3 months. The RS-fMRI processing protocol comprises the evaluation of functional and effective connectivity within the default mode network. Seed-to-voxel and ROI-to-ROI feature analysis was performed as starting point for a supervised machine-learning approach. Classification of the Cerebral Performance Category (CPC) 1-3 (good to acceptable outcome) versus CPC 4-5 (adverse outcome) achieved a positive predictive value of 91.7%, sensitivity of 90.2%, and accuracy of 87.8%. A direct link to the level of consciousness and outcome after 3 months was identified for measures of segregation in the precuneus, in medial and right frontal regions. Thalamic connectivity appeared significantly reduced in patients without conscious response. Decreased within-network connectivity in the default mode network and within cortico-thalamic circuits correlated with clinical outcome after 3 months. Our results indicate a potential role of these markers for decision-making in comatose patients early after cardiac arrest. Disorders of consciousness are a consequence of pathologies that affect an individual's ability to interact with the external world. Many factors contribute to disruption of consciousness, e.g., metabolic, epileptic, traumatic, and hypoxemic events, eventually ending in severe brain damage 1. Disruption of consciousness is categorized by different levels of quantitative impairment: to describe global states as levels of consciousness implies that there are degrees of consciousness and that changes in the global state of consciousness can be represented as changes along a clinical scoring system. Three distinct "stages" of altered consciousness have been describedcoma, vegetative state (VS), and minimally conscious state. The differentiation between the stages is based on behavioral criteria 2. Many coma scales have been developed; these include the

Introduction It has been shown that early central venous oxygen saturation (ScvO 2 )-guided optimization of hemodynamics can improve outcome in septic patients. The early ScvO 2 profile of other patient groups is unknown. The aim of this study was to characterize unplanned admissions in a multidisciplinary intensive care unit (ICU) with respect to ScvO 2 and outcome.

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