Cerebral blood flow is decoupled from blood pressure and linked to EEG bursting after resuscitation from cardiac arrest

Christian Crouzet; Robert H Wilson; Afsheen Bazrafkan; Maryam H Farahabadi; Donald Lee; Juan Alcocer; Bruce J Tromberg; Bernard Choi; Yama Akbari

doi:10.1364/BOE.7.004660

Cerebral blood flow is decoupled from blood pressure and linked to EEG bursting after resuscitation from cardiac arrest

Biomed Opt Express. 2016 Oct 20;7(11):4660-4673. doi: 10.1364/BOE.7.004660. eCollection 2016 Nov 1.

Authors

Christian Crouzet¹, Robert H Wilson², Afsheen Bazrafkan³, Maryam H Farahabadi⁴, Donald Lee³, Juan Alcocer³, Bruce J Tromberg⁵, Bernard Choi⁶, Yama Akbari⁴

Affiliations

¹ Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92617, USA; Department of Biomedical Engineering, University of California, Irvine, CA 92697, USA.
² Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92617, USA.
³ Department of Neurology, University of California, Irvine, CA 92697, USA.
⁴ Department of Neurology, University of California, Irvine, CA 92697, USA; School of Medicine, University of California, Irvine, CA 92697, USA.
⁵ Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92617, USA; Department of Biomedical Engineering, University of California, Irvine, CA 92697, USA; Department of Surgery, University of California, Irvine, CA 92868, USA.
⁶ Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92617, USA; Department of Biomedical Engineering, University of California, Irvine, CA 92697, USA; Department of Surgery, University of California, Irvine, CA 92868, USA; Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California, Irvine, CA 92697, USA.

Abstract

In the present study, we have developed a multi-modal instrument that combines laser speckle imaging, arterial blood pressure, and electroencephalography (EEG) to quantitatively assess cerebral blood flow (CBF), mean arterial pressure (MAP), and brain electrophysiology before, during, and after asphyxial cardiac arrest (CA) and resuscitation. Using the acquired data, we quantified the time and magnitude of the CBF hyperemic peak and stabilized hypoperfusion after resuscitation. Furthermore, we assessed the correlation between CBF and MAP before and after stabilized hypoperfusion. Finally, we examined when brain electrical activity resumes after resuscitation from CA with relation to CBF and MAP, and developed an empirical predictive model to predict when brain electrical activity resumes after resuscitation from CA. Our results show that: 1) more severe CA results in longer time to stabilized cerebral hypoperfusion; 2) CBF and MAP are coupled before stabilized hypoperfusion and uncoupled after stabilized hypoperfusion; 3) EEG activity (bursting) resumes after the CBF hyperemic phase and before stabilized hypoperfusion; 4) CBF predicts when EEG activity resumes for 5-min asphyxial CA, but is a poor predictor for 7-min asphyxial CA. Together, these novel findings highlight the importance of using multi-modal approaches to investigate CA recovery to better understand physiological processes and ultimately improve neurological outcome.

Keywords: (110.6150) Speckle imaging; (120.5475) Pressure measurement; (170.1610) Clinical applications; (170.2655) Functional monitoring and imaging; (170.3880) Medical and biological imaging; (170.5380) Physiology.

Abstract

Grants and funding