Neurologic recovery after ten minutes of absent cerebral blood flow at normothermia

Abstract

Prolonged normothermic cardiac arrest is associated with a high incidence of neurological morbidity and mortality. Whole body temperature-controlled perfusion has been applied to limit reperfusion injury and minimize ischemia. We describe the full recovery of a patient after the application of rapid hypothermia following an intraoperative aortic rupture with ten minutes of absent cerebral blood flow.

Application of cardiac surgery techniques to improve the results of cardiopulmonary resuscitation after cardiac arrest: Controlled automated reperfusion of the whole body

“…The resulting clinical data of preliminary pilot studies using this new technique are very promising. [54][55][56] In the preliminary clinical study, 7 out of 14 surviving patients regained full consciousness, whereas 6 of these 7 were assigned to cerebral performance class 1. 55 However, before any meaningful conclusions can be drawn, the ongoing multicenter, European clinical study (postmarket clinical follow-up) (DRKS00018967), sponsored by a European Union grant (Horizon 2020) has to be finalized.…”

“…The resulting clinical data of preliminary pilot studies using this new technique are very promising. 54 , 55 , 56 In the preliminary clinical study, 7 out of 14 surviving patients regained full consciousness, whereas 6 of these 7 were assigned to cerebral performance class 1. 55 …”

Machine Learning with Objective Serum Markers and Algorithmic Deep Learning CT Scan Analysis Predicts Brain Death Due to Trauma and Hypoxia

“…4 Recent advances in whole body temperature-controlled perfusion allowed for full neurological recovery after 10 minutes of prolonged asystole with hypothermia. 5 Rare cases of "recovery after neurologic death" may further obfuscate both clinician and layperson understanding of the reversibility of brain death. 6 The mechanistic heterogeneity of severe brain injury 7 implies that some injuries may potentially be more reversible than others.…”

Commentary: Restorative resuscitation after cardiac arrest with Controlled Automated Reperfusion of the whoLe body (CARL)—the Freiburg approach with guiding principles from cardiac surgery

“… 3 , 6 Furthermore, the pilot data are promising, suggesting clinical efficacy of this curated approach to extracorporeal life support. 3 , 6 , 7 …”

“… 1 , 2 , 3 , 4 , 5 Their platform could also direct further optimization of the metabolic milieu for additional organ protection during reperfusion. 3 , 6 , 7 …”