Ancillary Imaging Tests for Confirmation of Brain Death

Ande, Sudharsana Rao; Shankar, Jai Jai Shiva

doi:10.5772/intechopen.86516

Cited by 1 publication

(1 citation statement)

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“…We have been the first to define the features of fatal brain injury on CTP maps as 'matched defect' in CBF and CBV. [24][25][26] We will capitalise on these unique CTP characteristics and aim to be able to better predict outcomes in CCAP at discharge.…”

Section: Ctp For Confirmation Of Poor Neurological Outcomementioning

confidence: 99%

CT perfusion for Assessment of poor Neurological outcome in Comatose Cardiac Arrest Patients (CANCCAP): protocol for a prospective study

Alcock,

Singh,

Wiens

et al. 2023

BMJ Open

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IntroductionCardiac arrest remains one of the most common causes of death with the majority occurring outside of hospitals (out of hospital cardiac arrest). Despite advancements in resuscitation management, approximately 50% of comatose cardiac arrest patients (CCAP) will suffer a severe unsurvivable brain injury. To assess brain injury, a neurological examination is conducted, however, its reliability in predicting outcomes in the first days following cardiac arrest is limited. Non-contrast CT is the most employed scan to assess hypoxic changes, even though it is not sensitive to early hypoxic-ischaemic changes in the brain. CT perfusion (CTP) has shown high sensitivity and specificity in brain death patients, although its use in predicting poor neurological outcome in CCAP has not yet been explored. The purpose of this study is to validate CTP for predicting poor neurological outcome (modified Rankin scale, mRS≥4) at hospital discharge in CCAP.Methods and analysisThe CT Perfusion for Assessment of poor Neurological outcome in Comatose Cardiac Arrest Patients study is a prospective cohort study funded by the Manitoba Medical Research Foundation. Newly admitted CCAP receiving standard Targeted Temperature Management are eligible. Patients undergo a CTP at the same time as the admission standard of care head CT. Admission CTP findings will be compared with the reference standard of an accepted bedside clinical assessment at the time of admission. Deferred consent will be used. The primary outcome is a binary outcome of good neurological status, defined as mRs<4 or poor neurological status (mRs≥4) at hospital discharge. A total of 90 patients will be enrolled.Ethics and disseminationThis study has been approved by the University of Manitoba Health Research Ethics Board. The findings from our study will be disseminated through peer-reviewed journals and presentations at local rounds, national and international conferences. The public will be informed at the end of the study.Trial registration numberNCT04323020.

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Section: Ctp For Confirmation Of Poor Neurological Outcomementioning

confidence: 99%