Crouzet Christian, Wilson Robert H, Bazrafkan Afsheen, Farahabadi Maryam H, Lee Donald, Alcocer Juan, Tromberg Bruce J, Choi Bernard, Akbari Yama
Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92617, USA; Department of Biomedical Engineering, University of California, Irvine, CA 92697, USA.
Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92617, USA.
Biomed Opt Express. 2016 Oct 20;7(11):4660-4673. doi: 10.1364/BOE.7.004660. eCollection 2016 Nov 1.
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.
在本研究中，我们开发了一种多模态仪器，它结合了激光散斑成像、动脉血压和脑电图（EEG），以定量评估窒息性心脏骤停（CA）及复苏前、中、后的脑血流量（CBF）、平均动脉压（MAP）和脑电生理。利用采集到的数据，我们量化了复苏后脑血流量充血峰值的时间和幅度以及稳定的低灌注情况。此外，我们评估了稳定低灌注前后脑血流量与平均动脉压之间的相关性。最后，我们研究了从CA复苏后脑电活动恢复的时间与脑血流量和平均动脉压的关系，并建立了一个经验预测模型来预测从CA复苏后脑电活动恢复的时间。我们的结果表明：1）更严重的CA导致达到稳定脑低灌注的时间更长；2）在稳定低灌注之前脑血流量与平均动脉压相互耦合，在稳定低灌注之后则解耦；3）脑电图活动（爆发）在脑血流量充血期之后且在稳定低灌注之前恢复；4）对于5分钟窒息性CA，脑血流量可预测脑电图活动何时恢复，但对于7分钟窒息性CA则是一个较差的预测指标。总之，这些新发现凸显了使用多模态方法研究CA恢复以更好地理解生理过程并最终改善神经学结果的重要性。
