Abstract 274: Drugs and Cardiac Arrest: Suffocate the Brain, Spare the Body?

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Anezi Uzendu ◽  
Mark McIntyre ◽  
Habeeb Suara ◽  
Alisha Alabre ◽  
Emmanuel Boateng ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Medical Center ◽  
Care Facility ◽  
Cardiac Risk ◽  
Spontaneous Circulation ◽  
The Body ◽  
Secondary Outcome ◽  
Drug Induced ◽  
Neurologic Recovery ◽  
Induced Cardiac Arrest

Background: Nearly 70,000 people die of a drug overdose every year. Yet, how drug induced cardiac arrests differ from presumed cardiac etiology cardiac arrests is not well described. In animal models, asphyxial arrests resemble drug induced arrests, demonstrating better hemodynamic profiles yet worse neurologic recovery. Theoretically, this is caused by hypoxemic but preserved perfusion prior to ultimate arrest. But, this has not been studied in humans. We hypothesize that drug induced cardiac arrests will have higher incidence of return of spontaneous circulation (ROSC) in all comers, yet worse neurologic recovery among hospitalized patients. Methods: From a large institutional dataset capturing all patients with out-of-hospital cardiac arrests admitted from 2011 to 2019, we assess the prevalence and outcomes of cardiac arrests, by drug-use status. Patients were excluded if the arrest was trauma induced, occurred in an extended care facility/nursing home, or if treatment was initiated at another medical center. The primary outcome was ROSC in all comers, and the secondary outcome was favorable neurologic function among those surviving to admission. Multivariable logistic regression was used to assess factors associated with differences in outcomes, accounting for traditional cardiac risk factors and arrest characteristics. Results: In total, 436 patients (57±10 years, 31.7% female, 58.5% non-white, 49.3% hypertensive, 28.4% diabetics, and 21.1% preceding coronary disease) were identified, including 94 (21.6%) with drug induced cardiac arrest. Of that total group 101 (23.2%) survived, to admission, 26.6% of the drug induced group and 22.2% of the presumed cardiac cohort, demonstrating no difference in ROSC (P=0.32). Among those that survived to admission, 8% (2/25) of the drug induced group had a favorable neurologic outcome, compared to 29.0% (22/76) of the cardiac induced group (P= 0.03). Following adjustment, the presence of presenting drug induced cardiac arrest remained associated with lower rates of neurologic recovery [OR 7.3 (1.03-51.6) P= 0.04]. There was no difference in survival to discharge. Conclusion: Drug induced cardiac arrest is associated with worse neurologic outcomes than presumed cardiac etiology cardiac arrests.

Pupillary Light Reflex Is Not Abolished by Epinephrine and Atropine Given During Advanced Cardiac Life Support in Patients Who Achieve Return of Spontaneous Circulation

2020 ◽  
pp. 088506662090680
Author(s):  
Natalie Achamallah ◽  
Jeffrey Fried ◽  
Rebecca Love ◽  
Yuri Matusov ◽  
Rohit Sharma
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Advanced Cardiac Life Support ◽  
Spontaneous Circulation ◽  
Pupillary Light Reflex ◽  
Return Of Spontaneous Circulation ◽  
Neurologic Recovery ◽  
Light Reflex ◽  
Pupillary Light ◽  
Hospital Cardiac Arrest

Introduction: Absence of pupillary light reflex (PLR) is a well-studied indicator of poor neurologic recovery after cardiac arrest. Interpretation of absent PLR is difficult in patients with hypothermia or hypotension, or who have electrolyte or acid-base disturbances. Additionally, many studies exclude patients who receive epinephrine or atropine from their analysis on the basis that these drugs are thought to abolish the PLR. This observational cohort study assessed for presence or absence of PLR in in-hospital cardiac arrest patients who received epinephrine with or without atropine during advanced cardiac life support and achieved return of spontaneous circulation (ROSC). Methods: Pupil size and reactivity were assessed in adult patients who had an in-hospital cardiac arrest, received epinephrine with or without atropine, and achieved ROSC. Measurements were taken using a NeurOptics NPi-200 infrared pupillometer. Results: Forty patients had pupillometry performed within 1 hour (median: 6 minutes) after ROSC. Of these only 1 (2.5%) patient had nonreactive pupils at first measurement after ROSC. The remaining 39 (97.5%) had reactive pupils. Of the 19 patients who had pupils checked within 3 minutes of ROSC, 100% had reactive pupils. Degree of pupil responsiveness was not correlated with cumulative dose of epinephrine. Ten patients received atropine in addition to epinephrine, including the sole patient with nonreactive pupils. The remaining 9 (90%) had reactive pupils. Conclusion: Epinephrine and atropine do not abolish the PLR in patients who achieve ROSC after in-hospital cardiac arrest. Lack of pupillary response in the post-arrest patient should not be attributed to these drugs.

scholarly journals Hipotermia terapêutica pós reanimação cardiorrespiratória: uma revisão bibliográfica

2013 ◽  
pp. 25
Author(s):  
Jaciana Emily de Souza
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Therapeutic Hypothermia ◽  
Neurological Complications ◽  
Recovery Phase ◽  
Spontaneous Circulation ◽  
The Body ◽  
Cardiorespiratory Arrest ◽  
Palabras Clave ◽  
The Central Nervous System

A hipotermia, estado de anormalidade no ser humano em que a temperatura está abaixo do normal, é o resultado da exposição do organismo ao frio intenso, independente da forma, quando os mecanismos reguladores, cutâneos e nervosos se exaurem rapidamente e a temperatura cai, a produção de calor é deprimida e o resfriamento do sistema nervoso central leva à supressão dos controles hipotalâmicos. A hipotermia terapêutica melhora os desfechos entre os sobreviventes comatosos após manobras de reanimação. Considerando sua recomendação formal para emprego terapêutico pós-recuperação da circulação espontânea na parada cardiorrespiratória, o objetivo deste estudo foi trazer as principais teorias relacionadas com a hipotermia terapêutica. A revisão foi feita através de pesquisa de artigos através das palavras-chave parada cardiorrespiratória, resfriamento, hipotermia, na base de dados eletrônicos. Os resultados revelou que a hipotermia terapêutica é um dos tratamentos mais bem sucedidas para a fase após recuperação da parada cardíaca, aumentando em 40% a chance do paciente ter alta sem complicações neurológicas maiores.Descritores: Hipotermia, Parada Cardiorrespiratória, Ressuscitação Cardiopulmonar. Therapeutic hypothermia after cardiopulmonary resuscitation: a literature reviewAbstract: Hypothermia, state of abnormality in humans in which the temperature is below normal, is the result of exposure of the body to intense cold, regardless of form, when regulators, skin and nervous mechanisms are exhausted quickly and the temperature drops, the heat production is depressed and the cooling of the central nervous system leads to suppression of hypothalamic controls. Therapeutic hypothermia improves outcomes in comatose survivors after resuscitation maneuvers. Considering its formal recommendation for therapy, post-return of spontaneous circulation after cardiac arrest, the objective of this study was to bring the main theories related to therapeutic hypothermia. The review was conducted by searching items via keywords cardiorespiratory arrest, cooling, hypothermia, on the basis of electronic data. The results showed that therapeutic hypothermia is one of the most successful treatments for the recovery phase after cardiac arrest, increasing by 40% the chance of the patient being discharged without major neurological complications. Descriptors: Hypothermia, Stop Cardiopulmonary, Cardiopulmonary Resuscitation. La hipotermia terapêutica tras la reanimación cardiopulmonar: una revisión de la literaturaResumen: La hipotermia, estado de anormalidad en los seres humanos en los que la temperatura es inferior a lo normal, es el resultado de la exposición del cuerpo al frío intenso, independientemente de su forma, cuando los reguladores, la piel y los mecanismos nerviosos se agotan rapidamente y la temperatura baja, el la producción de calor es deprimida y el esfriamiento del sistema nervioso central conduce a la supresión de los controles hipotalámicos. La hipotermia terapéutica mejora los resultados en los supervivientes comatosos tras las maniobras de reanimación. Teniendo en cuenta su recomendación formal para la terapia, después de la recuperación de la circulación espontánea después de un paro cardíaco, el objetivo de este estudio fue el de traer las principales teorías relacionadas con la hipotermia terapéutica. La revisión se llevó a cabo mediante la búsqueda a través de palabras clave artículos parada cardiorrespiratoria, la refrigeración, la hipotermia, sobre la base de los datos electrónicos. Los resultados mostraron que la hipotermia terapéutica es uno de los tratamientos más exitosos para la fase de recuperación después de un paro cardíaco, aumentando en un 40% la posibilidad de que el paciente que está siendo descargada sin mayores complicaciones neurológicas. Descriptores: Hipotermia, Parada Cardiopulmonar, Resucitación Cardiopulmonar.

scholarly journals How many prehospital defibrillation attempts should be performed in out-of-hospital cardiac arrest patients with shockable rhythm?

2020 ◽  
Author(s):  
Byuk Sung Ko ◽  
Youn-Jung Kim ◽  
Kap Su Han ◽  
You Hwan Jo ◽  
Jonghwan Shin ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Odds Ratio ◽  
Cerebral Performance Category ◽  
Spontaneous Circulation ◽  
Neurologic Outcome ◽  
Secondary Outcome ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Shockable Rhythm ◽  
Good Neurologic Outcome ◽  
Hospital Cardiac Arrest

Abstract Background: Early defibrillation is vital to improve outcomes after out-of-hospital cardiac arrest (OHCA) with shockable rhythm. Currently, there is no agreed consensus on the number of defibrillation attempts before transfer to a hospital. This study aimed to evaluate the correlation between the number of defibrillations on the prehospital return of spontaneous circulation (ROSC).Methods: A multicenter, prospective, observational registry-based study was conducted for OHCA in patients with presumed cardiac etiology that underwent prehospital defibrillation between October 2015 and June 2017. The primary outcome was prehospital ROSC, and the secondary outcome was a good neurologic outcome at hospital discharge, defined as Cerebral Performance Category score 1 or 2. Results: Among 2,155 OHCA patients’ data, 178 patients with missing data were excluded, a total of 1,983 OHCA patients who received prehospital defibrillation were included. The median age was 61 years and prehospital ROSC was observed in 738 patients (37.2%). The median time from arrest to first defibrillation was 10 (interquartile range: 7-15) minutes. The cumulative ROSC rates and good neurologic outcome from the initial defibrillation to the sixth defibrillation were 43%, 68%, 81%, 90%, 95%, 98% and 42%, 66%, 81%, 90%, 95%, 98%, respectively. After clinical characteristics adjustment and time to defibrillation, the number of defibrillations were independently associated with ROSC (odds ratio 0.81 95% CI 0.76-0.86) and good neurologic outcome (odds ratio 0.86 95% CI 0.80-0.91). Moreover, subgroup analysis results with patients that underwent the initial defibrillation within 10 minutes from arrest were consistent (95% up to five times).Conclusion: More than 95% of prehospital ROSC was achieved within five times of defibrillation in OHCA patients. This result provides a basis for the ideal number of defibrillation attempts before transfer to hospital with the possibility of extracorporeal cardiopulmonary resuscitation in these refractory ventricular fibrillation patients.

scholarly journals Hipotermia terapêutica pós reanimação cardiorrespiratória: uma revisão bibliográfica

2013 ◽  
Vol 3 (8) ◽  
pp. 25
Author(s):  
Jaciana Emily de Souza
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Therapeutic Hypothermia ◽  
Neurological Complications ◽  
Recovery Phase ◽  
Spontaneous Circulation ◽  
The Body ◽  
Cardiorespiratory Arrest ◽  
Palabras Clave ◽  
The Central Nervous System

A hipotermia, estado de anormalidade no ser humano em que a temperatura está abaixo do normal, é o resultado da exposição do organismo ao frio intenso, independente da forma, quando os mecanismos reguladores, cutâneos e nervosos se exaurem rapidamente e a temperatura cai, a produção de calor é deprimida e o resfriamento do sistema nervoso central leva à supressão dos controles hipotalâmicos. A hipotermia terapêutica melhora os desfechos entre os sobreviventes comatosos após manobras de reanimação. Considerando sua recomendação formal para emprego terapêutico pós-recuperação da circulação espontânea na parada cardiorrespiratória, o objetivo deste estudo foi trazer as principais teorias relacionadas com a hipotermia terapêutica. A revisão foi feita através de pesquisa de artigos através das palavras-chave parada cardiorrespiratória, resfriamento, hipotermia, na base de dados eletrônicos. Os resultados revelou que a hipotermia terapêutica é um dos tratamentos mais bem sucedidas para a fase após recuperação da parada cardíaca, aumentando em 40% a chance do paciente ter alta sem complicações neurológicas maiores.Descritores: Hipotermia, Parada Cardiorrespiratória, Ressuscitação Cardiopulmonar. Therapeutic hypothermia after cardiopulmonary resuscitation: a literature reviewAbstract: Hypothermia, state of abnormality in humans in which the temperature is below normal, is the result of exposure of the body to intense cold, regardless of form, when regulators, skin and nervous mechanisms are exhausted quickly and the temperature drops, the heat production is depressed and the cooling of the central nervous system leads to suppression of hypothalamic controls. Therapeutic hypothermia improves outcomes in comatose survivors after resuscitation maneuvers. Considering its formal recommendation for therapy, post-return of spontaneous circulation after cardiac arrest, the objective of this study was to bring the main theories related to therapeutic hypothermia. The review was conducted by searching items via keywords cardiorespiratory arrest, cooling, hypothermia, on the basis of electronic data. The results showed that therapeutic hypothermia is one of the most successful treatments for the recovery phase after cardiac arrest, increasing by 40% the chance of the patient being discharged without major neurological complications. Descriptors: Hypothermia, Stop Cardiopulmonary, Cardiopulmonary Resuscitation. La hipotermia terapêutica tras la reanimación cardiopulmonar: una revisión de la literaturaResumen: La hipotermia, estado de anormalidad en los seres humanos en los que la temperatura es inferior a lo normal, es el resultado de la exposición del cuerpo al frío intenso, independientemente de su forma, cuando los reguladores, la piel y los mecanismos nerviosos se agotan rapidamente y la temperatura baja, el la producción de calor es deprimida y el esfriamiento del sistema nervioso central conduce a la supresión de los controles hipotalámicos. La hipotermia terapéutica mejora los resultados en los supervivientes comatosos tras las maniobras de reanimación. Teniendo en cuenta su recomendación formal para la terapia, después de la recuperación de la circulación espontánea después de un paro cardíaco, el objetivo de este estudio fue el de traer las principales teorías relacionadas con la hipotermia terapéutica. La revisión se llevó a cabo mediante la búsqueda a través de palabras clave artículos parada cardiorrespiratoria, la refrigeración, la hipotermia, sobre la base de los datos electrónicos. Los resultados mostraron que la hipotermia terapéutica es uno de los tratamientos más exitosos para la fase de recuperación después de un paro cardíaco, aumentando en un 40% la posibilidad de que el paciente que está siendo descargada sin mayores complicaciones neurológicas. Descriptores: Hipotermia, Parada Cardiopulmonar, Resucitación Cardiopulmonar.

scholarly journals Utility of opening rhythms in predicting time to return of spontaneous circulation in cardiac arrest victims in a resource constrained setting: a single centre prospective observational study

2019 ◽  
Vol 7 (12) ◽  
pp. 4709
Author(s):  
Appu Suseel ◽  
Siju V. Abraham ◽  
Radha K. R.
Keyword(s):  
Cardiac Arrest ◽  
Hospital Discharge ◽  
Cardiopulmonary Arrest ◽  
Spontaneous Circulation ◽  
Secondary Outcome ◽  
Resource Constrained ◽  
Return Of Spontaneous Circulation ◽  
Shockable Rhythm ◽  
Significant Difference ◽  
Mean Time

Background: Time to ROSC has been shown to be an important and independent predictor of mortality and adverse neurological outcome. In resource limited situations judicious deployment of resources is crucial. Prognostication of arrest victims may aid in better resource allocation. This study aimed to assess the time to Return of Spontaneous Circulation (ROSC) in cardiac arrest victims and its relationship with opening rhythms.Methods: Consecutive victims of cardiopulmonary arrest who presented to a single center were included in this study if they met the inclusion and exclusion criteria. Time at which opening rhythm was analyzed and time at which ROSC was achieved was noted. This was done for all cases and mean time to ROSC was calculated for each opening rhythm. All those patients who achieved ROSC were followed up till hospital discharge or death.  Primary outcome measured was achievement of ROSC and the secondary outcome was the survival to hospital discharge.Results: A sample size of 100 was calculated to yield a significance criterion of 0.05 and a power of 0.80 based on prior studies. Out of 100 patients studied. 58% had shockable rhythms and 42% had non-shockable rhythms.  Mean time to ROSC for shockable rhythm was 5.55±3.51 minutes, and for non-shockable rhythm is 17.29±4.18 minutes.  There was a statistically significant difference between opening rhythms in terms of survival to hospital discharge (p=0.0329).Conclusions: Cardiac arrests with shockable rhythms attained ROSC faster when compared to nonshockable rhythms. Shockable rhythms have a better survival to hospital discharge when compared to shockable rhythms. Opening rhythms may aid the clinician in better utility of resources in a resource constrained setting.

scholarly journals The effect of high-dose intramuscular epinephrine on the recovery of spontaneous circulation in an asphyxia‐induced cardiac arrest rat model

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daesung Lim ◽  
Soo Hoon Lee ◽  
Dong Hoon Kim ◽  
Changwoo Kang ◽  
Jin Hee Jeong ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Rat Model ◽  
Saline Group ◽  
Spontaneous Circulation ◽  
Rank Test ◽  
High Dose ◽  
Sprague Dawley ◽  
Epinephrine Administration ◽  
Arterial Blood ◽  
Induced Cardiac Arrest

Abstract Background Obtaining vascular access can be challenging during resuscitation following cardiac arrest, and it is particularly difficult and time-consuming in paediatric patients. We aimed to compare the efficacy of high-dose intramuscular (IM) versus intravascular (IV) epinephrine administration with regard to the return of spontaneous circulation (ROSC) in an asphyxia-induced cardiac arrest rat model. Methods Forty-five male Sprague-Dawley rats were used for these experiments. Cardiac arrest was induced by asphyxia, and defined as a decline in mean arterial pressure (MAP) to 20 mmHg. After asphyxia-induced cardiac arrest, the rats were randomly allocated into one of 3 groups (control saline group, IV epinephrine group, and IM epinephrine group). After 540 s of cardiac arrest, cardiopulmonary resuscitation was performed, and IV saline (0.01 cc/kg), IV (0.01 mg/kg, 1:100,000) epinephrine or IM (0.05 mg/kg, 1:100,000) epinephrine was administered. ROSC was defined as the achievement of an MAP above 40 mmHg for more than 1 minute. Rates of ROSC, haemodynamics, and arterial blood gas analysis were serially observed. Results The ROSC rate (61.5%) of the IM epinephrine group was less than that in the IV epinephrine group (100%) but was higher than that of the control saline group (15.4%) (log-rank test). There were no differences in MAP between the two groups, but HR in the IM epinephrine group (beta coefficient = 1.02) decreased to a lesser extent than that in the IV epinephrine group with time. Conclusions IM epinephrine induced better ROSC rates compared to the control saline group in asphyxia-induced cardiac arrest, but not compared to IV epinephrine. The IM route of epinephrine administration may be a promising option in an asphyxia-induced cardiac arrest.

scholarly journals Successful Treatment of Severe Electrolyte Imbalance-Induced Cardiac Arrest Caused by Adrenal Tuberculosis With ECMO in The ED

2021 ◽  
Author(s):  
Ning Yang ◽  
Liping Zhou ◽  
Xiaoye Mo ◽  
Guoqing Huang ◽  
Ping Wu
Keyword(s):  
Infectious Disease ◽  
Cardiac Arrest ◽  
Sudden Cardiac Arrest ◽  
Good Prognosis ◽  
Spontaneous Circulation ◽  
The Body ◽  
Electrolyte Imbalance ◽  
Multiple Organs ◽  
Cardiac Shock ◽  
Tuberculosis Therapy

Abstract Background Tuberculosis (TB) is a chronic infectious disease, common in China. TB bacteria can invade multiple organs throughout the body, but they rarely cause critical illness. We present a complex critically ill case in this report. Case presentation A 40-year-old man suffered sudden cardiac arrest during an emergency room visit. Spontaneous circulation resumed after emergency cardiopulmonary resuscitation (CPR), but recurrent ventricular fibrillation and refractory cardiac shock emerged. Thereafter, extracorporeal membrane oxygenation (ECMO) was implemented to maintain hemodynamic stability. Blood test results revealed that the patient had severe electrolyte imbalance and adrenal insufficiency. Further imaging examination showed multiple tuberculosis lesions throughout the body, including the lungs, adrenal glands, and lumbar spine. In the end, the patient was successfully moved from the ICU after weaning from ECMO and the ventilator, and then transferred to an infectious disease specialist hospital for standard anti-tuberculosis therapy. Conclusions ECMO has won the opportunity for the diagnosis and treatment of this young patient who suffered from a rare cause of cardiac arrest, and finally achieved a good prognosis.

scholarly journals Post-cardiac arrest syndrome in adult hospitalized patients

2021 ◽  
Author(s):  
Estivalis G. Acosta-Gutiérrez ◽  
Andrés M. Alba-Amaya ◽  
Santiago Roncancio-Rodríguez ◽  
José Ricardo Navarro-Vargas
Keyword(s):  
Cardiac Arrest ◽  
Latin American ◽  
Myocardial Dysfunction ◽  
Spontaneous Circulation ◽  
Neurologic Recovery ◽  
One Year ◽  
Meta Analyses ◽  
Post Cardiac Arrest Syndrome ◽  
Hospital Cardiac Arrest

Adult In-hospital Cardiac Arrest (IHCA) is defined as the loss of circulation of an in-patient. Following high-quality cardiopulmonary resuscitation (CPR), if the return of spontaneous circulation (ROSC) is achieved, the post-cardiac arrest syndrome develops (PCAS). This review is intended to discuss the current diagnosis and treatment of PCAS. To approach this topic, a bibliography search was conducted through direct digital access to the scientific literature published in English and Spanish between 2014 and 2020, in MedLine, SciELO, Embase and Cochrane. This search resulted in 248 articles from which original articles, systematic reviews, meta-analyses and clinical practice guidelines were selected for a total of 56 documents. The etiologies may be divided into 56% of in-hospital cardiac, and 44% of non-cardiac arrests. The incidence of this physiological collapse is up to 1.6 cases/1,000 patients admitted, and its frequency is higher in the intensive care units (ICU), with an overall survival rate of 13% at one year. The primary components of PCAS are brain injury, myocardial dysfunction and the persistence of the precipitating pathology. The mainstays for managing PCAS are the prevention of cardiac arrest, ventilation support, control of peri-cardiac arrest arrythmias, and interventions to optimize neurologic recovery. A knowledgeable healthcare staff in PCAS results in improved patient survival and future quality of life. Finally, there is clear need to do further research in the Latin American Population.

Abstract 18713: Quantification of Cortical Recovery After Cardiac Arrest With Continuous Somatosensory Evoked Potentials

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Nicole L Werner ◽  
Joshua Mergos ◽  
Liqun Sun ◽  
Trevor Tooley ◽  
Fares Alghanem ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Evoked Potentials ◽  
Somatosensory Evoked Potentials ◽  
Life Support ◽  
Total Duration ◽  
Advanced Cardiac Life Support ◽  
Spontaneous Circulation ◽  
Cortical Function ◽  
Neurologic Recovery ◽  
Rate Of Increase

Objective: Reliable early prognostication of neurologic recovery in comatose cardiac arrest (CA) survivors remains a major clinical challenge. We hypothesized that continuous somatosensory evoked potentials (SSEP) in the immediate post-CA period could enable early quantification of cortical recovery. Methods: Pigs were instrumented for hemodynamic and SSEP monitoring. For SSEP, stimulation was applied to the right median nerve and electrodes in the brachial plexus and scalp acquired recordings. The primary cortical signal was the N20. Animals were then subjected to ventricular fibrillation CA that was left untreated for up to 4 minutes and followed by advanced cardiac life support until return of spontaneous circulation (ROSC). SSEP monitoring started before CA and continued after ROSC until SSEPs were unchanged for 60 minutes. Results: Six experiments were performed. In all animals, peripheral, subcortical, and cortical SSEPs were acquired prior to CA, demonstrating morphology similar to that of humans. Cortical potentials completely disappeared during CA. Average arrest duration was 6.9 ± 3.0 min. After ROSC, the N20 signal returned but with variable recovery rate and amplitude. The final N20 amplitude inversely trended with total duration of arrest (Figure 1). The N20 amplitude recovery over time took a logarithmic shape and ranged from 5 to 180 minutes to reach maximum (Figure 2). Conclusions: Continuous SSEP monitoring allows for quantification of cortical recovery within hours of short duration CA in a porcine model. The maximum N20 amplitude and rate of increase may be useful tools for quantifying recovery of cortical function in comatose cardiac arrest survivors.

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