Blood-brain barrier permeability for the first 24 hours in hypoxic-ischemic brain injury following cardiac arrest

被引：3

作者：

You, Yeonho ^{[1
,2
]}

Park, Jung Soo ^{[1
,2
]}

Min, Jin Hong ^{[2
,3
]}

Jeong, Wonjoon ^{[1
,2
]}

Ahn, Hong Joon ^{[1
,2
]}

In, Yong Nam ^{[2
,3
]}

Jeon, So Young ^{[1
,2
]}

Lee, Jae Kwang ^{[4
]}

Kang, Changshin ^{[1
,2
]}

机构：

[1] Chungnam Natl Univ Hosp, Dept Emergency Med, 282 Munhwa Ro, Daejeon, South Korea

[2] Chungnam Natl Univ, Dept Emergency Med, Coll Med, 282 Mokdong Ro, Daejeon, South Korea

[3] Chungnam Natl Univ, Sejong Hosp, Dept Emergency Med, 20 Bodeum 7 Ro, Sejong, South Korea

[4] Konyang Univ Hosp, Coll Med, Dept Emergency Med, Daejeon 35365, South Korea

来源：

RESUSCITATION | 2024年 / 198卷

关键词：

Cardiac arrest; Blood-brain barrier; Hypoxia-ischaemia; Brain; RESUSCITATION; DEATH; HYPOTHERMIA; VALIDATION; DISRUPTION; ADMISSION; PRESSURE; SURVIVAL; EDEMA; SCORE;

D O I：

10.1016/j.resuscitation.2024.110150

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: This study aimed to explore the changes in blood-brain barrier (BBB) permeability and intracranial pressure (ICP) for the first 24 h after the return of spontaneous circulation (ROSC) and their association with injury severity of cardiac arrest. Methods: This prospective study analysed the BBB permeability assessed using the albumin quotient (Qa) and ICP every 2 h for the first 24 h after ROSC. The injury severity of cardiac arrest was assessed using Pittsburgh Cardiac Arrest Category (PCAC) scores. The primary outcome was the time course of changes in the BBB permeability and ICP for the first 24 h after ROSC and their association with injury severity (PCAC scores of 1-4). Results: Qa and ICP were measured 274 and 197 times, respectively, in 32 enrolled patients. Overall, the BBB permeability increased progressively over time after ROSC, and then it increased significantly at 18 h after ROSC compared with the baseline. In contrast, the ICP revealed non-significant changes for the first 24 h after ROSC. The Qa in the PCAC 2 group was < 0.01, indicating normal or mild BBB disruption at all time points, whereas the PCAC 3 and 4 groups showed a significant increase in BBB permeability at 14 and 22 h, and 12 and 14 h after ROSC, respectively. Conclusion: BBB permeability increased progressively over time for the first 24 h after ROSC despite post-resuscitation care, whereas ICP did not change over time. BBB permeability has an individual pattern when stratified by injury severity.

引用

页数：10

共 49 条

[1] Structure and function of the blood-brain barrier [J].